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Dietary Cholesterol, Serum Cholesterol, and Colon Cancer: A Review

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Essential Nutrients in Carcinogenesis

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Abstract

Observational and case-control epidemiologic data supported by experimental studies indicate that dietary cholesterol may contribute to colon tumorigenesis. A mechanism for this possible relationship is currently under investigation. Additional international epidemiologic data, although not uniformly consistent, indicate an inverse relationship between serum or plasma cholesterol levels and risk for colon cancer. This risk is greatest at serum cholesterol levels of less than 180 mg/dl. It has been suggested but not proven that individuals consuming diets high in dietary fat and cholesterol may have variations in cholesterol dynamics that account for lowered serum cholesterol levels and enhanced risk for colon cancer. Clinical evidence in both men and women indicates that age-sex-adjusted, low serum cholesterol levels may precede the detection of colon cancer by more than 5 years. Preclinical colon cancer is associated with a further decrease in serum cholesterol levels. It is not clear whether progression of the disease before metastatic spread results in continued lowering of serum cholesterol levels. In men with markedly elevated serum cholesterol levels who have been placed on cholesterol-lowering drugs such as clofibrate or cholestyramine, there was no evidence that such regimens increased the risk for colon cancer. It is possible that reductions in serum cholesterol associated with the use of these drugs are insufficient to lower cholesterol levels to a range associated with an increased risk for colon cancer.

Supported in part by grants CA 16750 and CA 38177 from the National Large Bowel Cancer Project and T32-CA 09423 from the National Cancer Institute, National Institutes of Health.

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Abbreviations

WHO:

World Health Organization

DMH:

1,2-dimethyl-hydrazine

MNU:

N-methyl-N-nitrosourea

CHD:

coronary heart disease

References

  1. Committee on Diet, Nutrition and Cancer, Assembly of Life Sciences, National Academy of Sciences, “Diet, Nutrition and Cancer,” National Academy Press, Washington, D.C. (1982).

    Google Scholar 

  2. M. Feinleib, On a possible inverse relationship between serum cholesterol and cancer mortality, Am. J. Epidemiol. 114:5 (1981).

    CAS  Google Scholar 

  3. A. M. Lilienfeld, The Humean fog: Cancer and cholesterol, Am. J. Epidemiol. 114:1 (1981).

    CAS  Google Scholar 

  4. M. Feinleib, Summary of a workshop on cholesterol and noncardiovascular disease mortality, Prev. Med. 11:360 (1982).

    Article  CAS  Google Scholar 

  5. A. B. Lowenfels, Is increased cholesterol excretion the link between low serum cholesterol and colon cancer? Nutr. Cancer 4:280 (1983).

    Article  CAS  Google Scholar 

  6. S. Sidney and J. W. Farquar, Cholesterol, cancer, and public health policy, Am. J. Med. 75:494 (1983).

    Article  CAS  Google Scholar 

  7. A. J. McMichael, O. M. Jensen, D. M. Parkin, et al., Dietary and endogenous cholesterol and human cancer, Epidemiol. Rev. 6:192 (1984).

    CAS  Google Scholar 

  8. K. Liu, D. Moss, V. Persky, et al., Dietary cholesterol, fat, and fiber, and colon-cancer mortality: An analysis of international data, Lancet 2:782 (1979).

    Article  CAS  Google Scholar 

  9. L. N. Kolonel, J. H. Hankin, J. Lee, et al., Nutrient intakes in relation to cancer incidence in Hawaii, Br. J. Cancer 44:332 (1981).

    Article  CAS  Google Scholar 

  10. M. Jain, G. M. Cook, F. G. Davis, et al., A case-control study of diet and colo-rectal cancer, Int. J. Cancer 26:757 (1980).

    Article  CAS  Google Scholar 

  11. J. P. Cruse, M. R. Lewin, G. P. Ferulano, et al., Co-carcinogenic effects of dietary cholesterol in experimental colon cancer, Nature 276:822 (1978).

    Article  CAS  Google Scholar 

  12. Y. Hiramatsu, H. Takada, M. Yamamura, et al., Effect of dietary cholesterol on azoxymethane-induced colon carcinogenesis in rats, Carcinogenesis 4:553 (1983).

    Article  CAS  Google Scholar 

  13. D. M. Klurfeld, E. Aglow, S. A. Tepper, et al., Modification of dimethylhydrazine-induced carcinogenesis in rats by dietary cholesterol, Nutr. Cancer 5:16 (1983).

    Article  CAS  Google Scholar 

  14. S. A. Broitman, H. Kupchick, L. S. Gottlieb, et al., Dietary cholesterol and colon tumorigenesis induced by 1,2-dimethylhydrazine or N-methyl-N-nitrosourea in rats, in: “Second International Conference on the Modulation and Mediation of Cancer by Vitamins and Micronutrients,” F. L. Meyskens and K. N. Prasad, eds., Humana Press, Clifton, N.J. (1985).

    Google Scholar 

  15. B. I. Cohen, R. F. Raicht, and E. Fazzini, Reduction of N-methyl-N- nitrosourea-induced colon tumors in the rat by cholesterol, Cancer Res. 42:5050 (1982).

    CAS  Google Scholar 

  16. G. Rose, H. Blackburn, A. Keys, et al., Colon cancer and blood cholesterol, Lancet 1:181 (1974).

    Article  CAS  Google Scholar 

  17. R. R. Williams, P. D. Sorlie, M. Feinlieb, et al., Cancer incidence by levels of cholesterol, J.A.M.A. 245:247 (1981).

    Article  CAS  Google Scholar 

  18. A. Kagan, D. L. McGee, K. Yano, et al., Serum cholesterol and mortality in Japanese-American population: The Honolulu Heart Program, An. J. Epidemiol. 114:11 (1981).

    CAS  Google Scholar 

  19. G. N. Stemmermann, A. M. Y. Nomura, L. K. Hellbrun, et al., Serum cholesterol and colon cancer incidence in Hawaii and Japanese men, J. Natl. Cancer Inst. 67:1179 (1981).

    CAS  Google Scholar 

  20. J. D. Kark, A. H. Smith, and C. G. Hames, The relationship of serum cholesterol to the incidence of cancer in Evans County, Georgia, J. Chronic Dis. 33:311 (1980).

    Article  CAS  Google Scholar 

  21. International Collaborative Group, Circulating cholesterol level and risk of death from cancer in men aged 40 to 69 years: Experience of an international collaborative group, J.A.M.A. 248:2853 (1982).

    Article  Google Scholar 

  22. S. R. Miller, P. I. Tartter, A. E. Papatestas, et al., Serum cholesterol and human colon cancer, J. Natl. Cancer Inst. 67:297 (1981).

    CAS  Google Scholar 

  23. J. Buchalter, E. Herbert, B. Flehinger, et al., A case-control study of time-trends in serum cholesterol levels prior to the detection of colon cancer (abstract), Gastroenterology 84:1403 (1983).

    Google Scholar 

  24. Report of the Committee of Principal Investigators: W.H.O. cooperative trial on primary prevention of ischaemic heart disease using clofibrate to lower serum cholesterol: Mortality follow-up, Lancet 2:379 (1980).

    Google Scholar 

  25. Lipid Research Clinics: Lipid Research Clinics coronary prevention trial results. I. Reduction in incidence of coronary heart disease, J.A.M.A. 251:351 (1984).

    Article  Google Scholar 

  26. P. D. Sorlie and M. Feinleib, The serum cholesterol-cancer relationship: An analysis of time trends in the Framingham Study, J. Natl. Cancer Inst. 69:989 (1982).

    CAS  Google Scholar 

  27. J. D. Kark, A. H. Smith, B. R. Switzer, et al., Retinol, carotene, and the cancer/cholesterol association, Lancet 2:1371 (1981).

    Article  Google Scholar 

  28. R. Peto, R. Doll, J. D. Buckley, et al., Can dietary β-carotene materially reduce human cancer rates? Nature 290:201 (1981).

    Article  CAS  Google Scholar 

  29. M. B. Sporn and D. L. Newton, Chemoprevention of cancer with retinoids, Fed. Proc. 38:2528 (1979).

    CAS  Google Scholar 

  30. N. Wald, M. Idle, A. Boreham, et al., Low serum vitamin A and subsequent risk of cancer, Lancet 2:813 (1980).

    Article  CAS  Google Scholar 

  31. E. Bjelke, Colon cancer and blood-cholesterol, Lancet 1:1116 (1974).

    Article  CAS  Google Scholar 

  32. V. T. DeVita, Jr., S. Hellman, and S. A. Rosenberg, “Cancer Principles and Practice of Oncology,” J. B. Lippincott Co., Philadelphia (1982).

    Google Scholar 

  33. J. L. Young, C. L. Percy, and H. A. Aseri, Surveillance epidemiology and end results: Incidence and mortality data 1973–1977, Natl. Cancer Inst. Monogr. 57:110 (1981).

    Google Scholar 

  34. S. A. Broitman, J. J. Vitale, E. Vavrousek-Jakuba, et al., Polyunsaturated fat, cholesterol and large bowel tumorigenesis, Cancer 40:2455 (1977).

    Article  CAS  Google Scholar 

  35. Report from the Committee of Principal Investigators: A cooperative trial in the primary prevention of ischaemic heart disease using clofibrate, Br. Heart J. 40:1069 (1978).

    Article  Google Scholar 

  36. N. D. Nigro, R. L. Campbell, J. S. Gantt, et al., A comparison of the hypocholesterolemic agents, cholestyramine and candicidin on the induction of intestinal tumors in rats by azoxymethane, Cancer Res. 37:3198 (1977).

    CAS  Google Scholar 

  37. N. D. Nigro, N. Bhadrachri, and C. Chomachai, A rat model for studying colonic cancer: Effect of cholestyramine on induced tumors, Dis. Colon Rectum 16:438 (1973).

    Article  CAS  Google Scholar 

  38. B. S. Reddy and K. Watanabe, Effect of cholesterol metabolites and promoting effect of lithocholic acid in colon carcinogenesis in germ-free and conventional F344 rats, Cancer Res. 39:1521 (1979).

    CAS  Google Scholar 

  39. A. J. McMichael and J. P. Potter, Reproduction, endogenous and exogenous sex hormones and colon cancer: A review and hypothesis, J. Natl. Cancer Inst. 65:1201 (1980).

    CAS  Google Scholar 

  40. S. A. Broitman, Cholesterol excretion and colon cancer, Cancer Res. 41:3738 (1981).

    CAS  Google Scholar 

  41. R. T. Waiden, L. E. Schaefer, F. R. Lemon, et al., Effect of the environment on the serum cholesterol-triglyceride distribution among Seventh Day Adventists, Am. J. Med. 36:269 (1964).

    Article  Google Scholar 

  42. R. L. Phillips, Role of life-style and dietary habits in risk of cancer among Seventh-Day Adventists, Cancer Res. 35:3513 (1975).

    CAS  Google Scholar 

  43. E. L. Wynder, The epidemiology of large bowel cancer, Cancer Res. 35:3388 (1975).

    CAS  Google Scholar 

  44. R. Reiser, Oversimplification of diet: Coronary heart disease relationships and exaggerated diet recommendations, Am. J. Clin. Nutr. 31:865 (1978).

    CAS  Google Scholar 

  45. J. Ferezou, T. Coste, and F. Chevallier, Origins of neutral sterols in human feces studied by stable isotope labeling (D and 13C). Existence of an external secretion of cholesterol, Digestion 21:232 (1981).

    Article  CAS  Google Scholar 

  46. C. Lutton, The role of the digestive tract in cholesterol metabolism, Digestion 14:342 (1976).

    Article  CAS  Google Scholar 

  47. M. J. Hill, B. S. Drasar, V. Aries, et al., Bacteria and aetiology of cancer of large bowel, Lancet 1:95 (1971).

    Article  CAS  Google Scholar 

  48. M. Moskowitz, C. White, R. N. Barnett, et al., Diet, faecal bile acids, and neutral sterols in carcinoma of the colon, Dig. Dis. Sci. 39:274 (1979).

    Google Scholar 

  49. M. J. Hill, B. S. Drasar, R. E. Williams, et al., Faecal bile-acids and Clostridia in patients with cancer of the large bowel, Lancet 1:535 (1975).

    Article  CAS  Google Scholar 

  50. M. Lipkin, B. S. Reddy, J. H. Weisburger, et al., Nondegradation of fecal cholesterol in subjects at high risk for cancer of the large intestine, J. Clin. Invest. 67:304 (1981).

    Article  CAS  Google Scholar 

  51. B. S. Reddy and E. L. Wynder, Metabolic epidemiology of colon cancer: Fecal bile acids and neutral sterols in colon cancer patients and patients with adenomatous polyps, Cancer 39:2533 (1977).

    Article  CAS  Google Scholar 

  52. D. S. Lin and D. S. Connor, The long term effects of dietary cholesterol upon the plasma lipids, lipoproteins, cholesterol absorption, and the sterol balance in man: The demonstration of feedback inhibition of cholesterol biosynthesis and increased bile acid excretion, J. Lipid Res. 21:1042 (1980).

    CAS  Google Scholar 

  53. R. J. Fry and E. Staffeldt, Effect of a diet containing sodium deoxy- cholate on the intestinal mucosa of the mouse, Nature 302:1396 (1964).

    Article  Google Scholar 

  54. R. Ranken, R. Wilson, and P. M. Bealmear, Increased turnover of intestinal mucosal cells of germfree mice induced by cholic acid, Proc. Soc. Exp. Biol. Med. 138:270 (1971).

    CAS  Google Scholar 

  55. E. E. Deschner and R. F. Raicht, The influence of bile on the kinetic behavior of colonic epithelial cells of the rat (abstract), Gastroenterology 76:1120 (1979).

    Google Scholar 

  56. R. H. Palmer, Editorial: Bile acid heterogeneity and the gastrointestinal epithelium: From diarrhea to colon cancer, J. Lab. Clin. Med. 94:655 (1979).

    CAS  Google Scholar 

  57. H. S. Mekhjian, S. F. Phillips, and A. F. Hofmann, Colonic secretion of water and electrolytes induced by bile acids in man, J. Clin. Invest. 50:1569 (1971).

    Article  CAS  Google Scholar 

  58. T. Narisawa, N. E. Magadia, J. H. Weisburger, et al., Promoting effect of bile acids on colon carcinogenesis after intrarectal instillation of N-methyl-N’-nitro-N-nitrosoguanidine in rats, J. Natl. Cancer Inst. 53:1093 (1974).

    CAS  Google Scholar 

  59. J. V. Nicolosi and S. A. Broitman, Augmentation of colon tumorigenesis by dietary cholesterol: Cholesterol uptake and biosynthesis by rat gastrointestinal tissues and tumors (abstract), Fed. Proc. 42:1835 (1983).

    Google Scholar 

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Author information

Authors and Affiliations

  1. Departments of Microbiology and Pathology, Boston University School of Medicine, Boston, Massachusetts, 02118, USA

    Selwyn A. Broitman

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  1. Selwyn A. Broitman
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Editors and Affiliations

  1. Laboratory of Comparative Carcinogenesis, National Cancer Institute, Frederick Cancer Research Facility, Frederick, Maryland, USA

    Lionel A. Poirier

  2. Department of Pathology, Boston University School of Medicine, Boston, Massachusetts, USA

    Paul M. Newberne

  3. Food Research Institute, University of Wisconsin, Madison, Wisconsin, USA

    Michael W. Pariza

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© 1986 Plenum Press, New York

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Broitman, S.A. (1986). Dietary Cholesterol, Serum Cholesterol, and Colon Cancer: A Review. In: Poirier, L.A., Newberne, P.M., Pariza, M.W. (eds) Essential Nutrients in Carcinogenesis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1835-4_13

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  • DOI: https://doi.org/10.1007/978-1-4613-1835-4_13

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-9025-4

  • Online ISBN: 978-1-4613-1835-4

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