Purpose: Some recent studies have suggested that higher total cholesterol levels are positively associated with risk of aggressive prostate cancer. However, evidence about this association is limited and few studies examined cholesterol subfractions. We therefore examined associations of total, LDL, and HDL cholesterol concentrations with subsequent risk of aggressive prostate cancer within the Cancer Prevention Study II Nutrition Cohort.
Methods: A total of 14,241 men with no history of cancer provided a blood sample between 1998 and 2001. During follow-up through 2007, 236 of these men were diagnosed with aggressive prostate cancer (AJCC stage ≥ III or Gleason score ≥ 7 (4 + 3)). Plasma total, LDL, and HDL cholesterol concentrations were measured in these 236 cases and 236 age and race-matched controls. Multivariable-adjusted odds ratios (OR) and 95 % confidence intervals (CI) were estimated using conditional logistic regression, adjusting for use of cholesterol-lowering drugs, history of heart attack, and physical activity.
Results: Neither total, LDL, nor HDL cholesterol concentrations were associated with risk of aggressive prostate cancer. OR's for a 1 standard deviation (SD) difference were 0.93 (95 % CI 0.76-1.14) for total cholesterol (SD = 33.7 mg/dl), 0.94 (95 % CI 0.77-1.15) for LDL cholesterol (SD = 30.3 mg/dl), and 0.97 (95 % CI 0.82-1.16) for HDL cholesterol (SD = 12.5 mg/dl). Results were similar in analyses excluding the first 2 years of follow-up or users of cholesterol-lowering drugs.
Conclusions: These results do not support an association between total cholesterol or its subfractions and risk of aggressive prostate cancer.