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Total cholesterol and cancer risk in a large prospective study in Korea

Authors
 Cari M. Kitahara  ;  Amy Berrington de Gonza´lez  ;  Neal D. Freedman  ;  Rachel Huxley  ;  Yejin Mok  ;  Sun Ha Jee  ;  Jonathan M. Samet 
Citation
 JOURNAL OF CLINICAL ONCOLOGY, Vol.29(12) : 1592-1598, 2011 
Journal Title
JOURNAL OF CLINICAL ONCOLOGY
ISSN
 0732-183X 
Issue Date
2011
MeSH
Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group/statistics & numerical data* ; Biomarkers/blood ; Cholesterol/blood* ; Female ; Humans ; Incidence ; Male ; Middle Aged ; National Health Programs ; Neoplasms/blood* ; Neoplasms/ethnology* ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors ; Time Factors
Abstract
PURPOSE: To further clarify the relationship between total cholesterol and cancer, which remains unclear.

METHODS: We prospectively examined the association between total cholesterol and site-specific and all-cancer incidence among 1,189,719 Korean adults enrolled in the National Health Insurance Corporation who underwent a standardized biennial medical examination in 1992 to 1995 and were observed for 14 years until cancer diagnosis or death.

RESULTS: Over follow-up, 53,944 men and 24,475 women were diagnosed with a primary cancer. Compared with levels less than 160 mg/dL, high total cholesterol (≥ 240 mg/dL) was positively associated with prostate cancer (hazard ratio [HR], 1.24; 95% CI, 1.07 to 1.44; P trend = .001) and colon cancer (HR, 1.12; 95% CI, 1.00 to 1.25; P trend = .05) in men and breast cancer in women (HR, 1.17; 95% CI, 1.03 to 1.33; P trend = .03). Higher total cholesterol was associated with a lower incidence of liver cancer (men: HR, 0.42; 95% CI, 0.38 to 0.45; P trend < .001; women: HR, 0.32; 95% CI, 0.27 to 0.39; P trend < .001), stomach cancer (men: HR, 0.87; 95% CI, 0.82 to 0.93; P trend ≤ .001; women: HR, 0.86; 95% CI, 0.77 to 0.97; P trend = .06), and, in men, lung cancer (HR, 0.89; 95% CI, 0.82 to 0.96; P trend < .001). Results for liver cancer were slightly attenuated after additional adjustment for liver enzyme levels and hepatitis B surface antigen status (men: HR, 0.60; P trend < .001; women: HR, 0.46; P trend = .003) and exclusion of the first 10 years of follow-up (men: HR, 0.59; P trend < .001; women: HR, 0.44; P trend < .001). Total cholesterol was inversely associated with all-cancer incidence in both men (HR, 0.84; 95% CI, 0.81 to 0.86; P trend < .001) and women (HR, 0.91; 95% CI, 0.87 to 0.95; P trend < .001), but these associations were attenuated after excluding incident liver cancers (men: HR, 0.95; P trend < .001; women: HR, 0.98; P trend = .32).

CONCLUSION: In this large prospective study, we found that total cholesterol was associated with the risk of several different cancers, although these relationships differed markedly by cancer site.
Files in This Item:
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DOI
10.1200/JCO.2010.31.5200
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Jee, Sun Ha(지선하) ORCID logo https://orcid.org/0000-0001-9519-3068
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93025
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