Cholesterol and the risk of grade-specific prostate cancer incidence: evidence from two large prospective cohort studies with up to 37 years' follow up

BMC Cancer

Kashif Shafique²  Philip McLoone⁴  Khaver Qureshi³  Hing Leung¹  Carole Hart²  David S Morrison⁴ 

[1] Beatson Institute for Cancer Research, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, UK

[2] Institute of Health & Wellbeing, Public Health, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK

[3] Urology Department, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK

[4] West of Scotland Cancer Surveillance Unit, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK

关键词: Gleason grade;    Incidence;    Prostate cancer;    Cholesterol;   

Others  :  1080582
DOI  :  10.1186/1471-2407-12-25

 received in 2011-09-01, accepted in 2012-01-19,  发布年份 2012

【 摘 要 】

Background

High cholesterol may be a modifiable risk factor for prostate cancer but results have been inconsistent and subject to potential "reverse causality" where undetected disease modifies cholesterol prior to diagnosis.

Methods

We conducted a prospective cohort study of 12,926 men who were enrolled in the Midspan studies between 1970 and 1976 and followed up to 31st December 2007. We used Cox-Proportional Hazards Models to evaluate the association between baseline plasma cholesterol and Gleason grade-specific prostate cancer incidence. We excluded cancers detected within at least 5 years of cholesterol assay.

Results

650 men developed prostate cancer in up to 37 years' follow-up. Baseline plasma cholesterol was positively associated with hazard of high grade (Gleason score≥8) prostate cancer incidence (n = 119). The association was greatest among men in the 2nd highest quintile for cholesterol, 6.1 to < 6.69 mmol/l, Hazard Ratio 2.28, 95% CI 1.27 to 4.10, compared with the baseline of < 5.05 mmol/l. This association remained significant after adjustment for body mass index, smoking and socioeconomic status.

Conclusions

Men with higher cholesterol are at greater risk of developing high-grade prostate cancer but not overall risk of prostate cancer. Interventions to minimise metabolic risk factors may have a role in reducing incidence of aggressive prostate cancer.

【 授权许可】

   
2012 Shafique et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Bray F, Lortet-Tieulent J, Ferlay J, Forman D, Auvinen A: Prostate cancer incidence and mortality trends in 37 European countries: an overview. Eur J Cancer 2010, 46:3040-3052.
• [2]Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al.: Cancer statistics, 2008. CA Cancer J Clin 2008, 58:71-96.
• [3]Johns LE, Houlston RS: A systematic review and meta-analysis of familial prostate cancer risk. BJU Int 2003, 91:789-794.
• [4]Sakr WA, Grignon DJ, Haas GP, Heilbrun LK, Pontes JE, Crissman JD: Age and racial distribution of prostatic intraepithelial neoplasia. Eur Urol 1996, 30:138-144.
• [5]Ben-Shlomo Y, Evans S, Ibrahim F, Patel B, Anson K, Chinegwundoh F, et al.: The risk of prostate cancer amongst black men in the United Kingdom: the PROCESS cohort study. Eur Urol 2008, 53:99-105.
• [6]Baade PD, Youlden DR, Krnjacki LJ: International epidemiology of prostate cancer: geographical distribution and secular trends. Mol Nutr Food Res 2009, 53:171-184.
• [7]White RM: On the occurrence of crystals in tumours. J Pathol Bacteriol 1909, 13:3-10.
• [8]Bravi F, Scotti L, Bosetti C, Talamini R, Negri E, Montella M, et al.: Self-reported history of hypercholesterolaemia and gallstones and the risk of prostate cancer. Ann of Oncol 2006, 17:1014-1017.
• [9]Hiatt RA, Fireman BH: Serum cholesterol and the incidence of cancer in a large cohort. J Chr Dis 1986, 39:861-870.
• [10]Kark JD, Smith AH, Hames CG: Serum retinol and the inverse relationship between serum cholesterol and cancer. Br Med J 1982, 284:152-154.
• [11]Knekt P, Reunanen A, Aromaa A, Heliovaara M, Hakulinen T, Hakama M: Serum cholesterol and risk of cancer in a cohort of 39,000 men and women. J Clin Epidemiol 1988, 41:519-530.
• [12]Davey Smith G, Shipley MJ, Marmot MG, Rose G: Plasma cholesterol concentration and mortality. The Whitehall Study. JAMA 1992, 267:70-76.
• [13]Thompson MM, Garland C, Barrett-Connor E, Khaw K-T, Friedlander NJ, Wingard DL: Heart disease risk factors, diabetes, and prostatic cancer in an adult community. Am J Epidemiol 1989, 129:511-517.
• [14]Batty GD, Kivimaki M, Clarke R, Davey Smith G, Shipley MJ: Modifiable risk factors for prostate cancer mortality in London: forty years of follow-up in the Whitehall study. Canc Causes Contr 2011, 22:311-318.
• [15]Mondul AM, Clipp SL, Helzlsouer KJ, Platz EA: Association between plasma total cholesterol concentration and incident prostate cancer in the CLUE II cohort. Canc Causes Contr 2010, 21:61-68.
• [16]Platz EA, Clinton SK, Giovannucci E: Association between plasma cholesterol and prostate cancer in the PSA era. Int J Cancer 2008, 123:1693-1698.
• [17]Platz EA, Till C, Goodman PJ, Parnes HL, Figg WD, Albanes D, et al.: Men with low serum cholesterol have a lower risk of high-grade prostate cancer in the placebo arm of the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 2009, 18:2807-2813.
• [18]Hart CL, MacKinnon PL, Watt GC, Upton MN, McConnachie A, Hole DJ, et al.: The Midspan studies. Int J Epidemiol 2005, 34:28-34.
• [19]Davey Smith G, Hart C, Hole D, MacKinnon P, Gillis C, Watt G, et al.: Education and occupational social class: Which is the more important indicator of mortality risk? J Epidemiol Community Health 1998, 52:153-160.
• [20]Hawthorne VM, Watt GC, Hart CL, Hole DJ, Davey Smith G, Gillis CR: Cardiorespiratory disease in men and women in urban Scotland: baseline characteristics of the Renfrew/Paisley (midspan) study population. Scott Med J 1995, 40:102-107.
• [21]Resnick MJ, Canter DJ, Guzzo TJ, Brucker BM, Bergey M, Sonnad SS, et al.: Does race affect postoperative outcomes in patients with low-risk prostate cancer who undergo radical prostatectomy? Urology 2009, 73:620-623.
• [22]General Register Office: Classification of Occupation. London: HMSO; 1966:1-136.
• [23]Giovannucci E, Liu Y, Platz EA, Stampfer MJ, Willett WC: Risk factors for prostate cancer incidence and progression in the health professionals follow-up study. Int J Cancer 2007, 121:1571-1578.
• [24]Hart CL, Batty GD, Morrison DS, Mitchell RJ, Davey Smith G: Obesity, overweight and liver disease in the Midspan prospective cohort studies. Int J Obesity 2010, 34:1051-1059.
• [25]Korn EL, Graubard BI, Midthune D: Time-to-event analysis of longitudinal follow-up of a survey: choice of the time-scale. Am J Epidemiol 1997, 145:72-80.
• [26]National Heart, Lung and Blood Institute: Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). In Bethesda, MD: National Heart, Lung, and Blood Institute of Health. NIH publication; 2002. 02-5215 accessed on 29th Nov, 2011
• [27]Lawlor DA, Hart CL, Hole DJ, Davey Smith G: Reverse causality and confounding and the associations of overweight and obesity with mortality. Obesity (Silver Spring) 2006, 14:2294-2304.
• [28]Van HM, Garmo H, Holmberg L, Walldius G, Jungner I, Hammar N, et al.: Prostate cancer risk in the Swedish AMORIS study: the interplay among triglycerides, total cholesterol, and glucose. Cancer 2011, 117:2086-95.
• [29]Mondul AM, Weinstein SJ, Virtamo J, Albanes D: Serum total and HDL cholesterol and risk of prostate cancer. Canc Causes Contr 2011, 22:1545-1552.
• [30]Freeman MR, Solomon KR: Cholesterol and prostate cancer. J Cell Biochem 2004, 91:54-69.
• [31]Hager MH, Solomon KR, Freeman MR: The role of cholesterol in prostate cancer. Curr Opin Clin Nutr Metab Care 2006, 9:379-385.
• [32]Oh HY, Lee EJ, Yoon S, Chung BH, Cho KS, Hong SJ: Cholesterol level of lipid raft microdomains regulates apoptotic cell death in prostate cancer cells through EGFR-mediated Akt and ERK signal transduction. Prostate 2007, 67:1061-1069.
• [33]Zhuang L, Lin J, Lu ML, Solomon KR, Freeman MR: Cholesterol-rich lipid rafts mediate akt-regulated survival in prostate cancer cells. Cancer Res 2002, 62:2227-2231.
• [34]Boudreau DM, Yu O, Buist DS, Miglioretti DL: Statin use and prostate cancer risk in a large population-based setting. Canc Causes Contr 2008, 19:767-774.
• [35]Browning DR, Martin RM: Statins and risk of cancer: a systematic review and metaanalysis. Int J Cancer 2007, 120:833-843.
• [36]Dale KM, Coleman CI, Henyan NN, Kluger J, White CM: Statins and cancer risk: a meta-analysis. JAMA 2006, 295:74-80.
• [37]Green J, Cairns BJ, Casabonne D, Wright FL, Reeves G, Beral V: Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk. Lancet Oncol 2011, 12:785-794.
• [38]Renehan AG: Height and cancer: consistent links, but mechanisms unclear. Lancet Oncol 2011, 12:716-717.
• [39]Schouten LJ, Rivera C, Hunter DJ, Spiegelman D, Adami HO, Arslan A, et al.: Height, body mass index, and ovarian cancer: a pooled analysis of 12 cohort studies. Cancer Epidemiol Biomarkers Prev 2008, 17:902-912.
• [40]Zuccolo L, Harris R, Gunnell D, Oliver S, Lane JA, Davis M, et al.: Height and prostate cancer risk: a large nested case-control study (ProtecT) and meta-analysis. Cancer Epidemiol Biomarkers Prev 2008, 17:2325-2336.
• [41]Neaton JD, Kuller LH, Wentworth D, Borhani NO: Total and cardiovascular mortality in relation to cigarette smoking, serum cholesterol concentration, and diastolic blood pressure among black and white males followed up for five years. Am Heart J 1984, 108:759-769.
• [42]Strandberg TE: Inverse relation between height and cardiovascular mortality in men during 30-year follow-up. Am J Cardiol 1997, 80:349-350.
• [43]Turley ML, Tobias M, Lawes CM, Stefanogiannis N, Vander HS, Mhurchu CN, et al.: Cardiovascular mortality attributable to high blood cholesterol in New Zealand. Aust N Z J Public Health 2006, 30:252-257.