Serum cholesterol and prostate cancer risk in the finnish randomized study of screening for prostate cancer

ABSTRACT BACKGROUND Hypercholesterolemia has been associated with advanced stage prostate cancer (PCa), but the role of lipid parameters such as HDL and triglycerides is unclear. We examined

PCa risk by lipid parameters in a population nested within the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC). METHODS Cholesterol measurements were available on 17,696

men. During the 17-year median follow-up, 2404 PCa cases were diagnosed. Cox regression model was used to estimate hazard ratios (HR) and their 95% confidence intervals (95% CI) for overall

PCa risk and stratified by Gleason grade and tumor stage. We compared normolipidemic and hyperlipidemic men on four cholesterol parameters total cholesterol (TC), HDL, LDL, and

triglycerides (TG), analyzed as time-dependent variables. RESULTS TC in the highest tertile (above 5.1 mmol/l) and LDL above 3 mmol/l were associated with increased risk of Gleason 8–10

cancer (HR 1.42, 95% CI 1.04–1.95 and HR 1.38, 95% CI 1.02–1.86, respectively). Further, overall PCa risk was elevated in the 3-year lag time analysis by TC in the highest two tertiles (HR

1.27, 95% CI 1.05–1.54 for TC above 4.4 mmol/l, and HR 1.26, 95% CI 1.05–1.51 for TC above 5.1 mmol/l) and HDL in the highest tertile (HR 1.33, 95% CI 1.08–1.64) and above 1 mmol/l (HR 1.29,

95% CI 1.01–1.65). In contrast, TC in the highest tertile was associated with a decreased risk of PCa with 20-year lag time. The risk associations for overall PCa grew stronger with added

lag time but were observed only in the FinRSPC control arm. Statin use did not modify the risk association. CONCLUSIONS Hypercholesterolemia may increase overall PCa risk in short-term,

inverse risk association was observed with 20-years’ time lag. Similar risk increase of overall PCa was also observed for elevated HDL, conflicting with previous findings on the subject.

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support SIMILAR CONTENT BEING VIEWED BY OTHERS PROSTATE CANCER PROGNOSIS AFTER INITIATION OF ANDROGEN DEPRIVATION THERAPY AMONG STATIN USERS. A POPULATION-BASED COHORT STUDY Article Open

access 31 March 2021 ASSOCIATION BETWEEN LOW DENSITY LIPOPROTEIN CHOLESTEROL LEVELS AND PROSTATE CANCER RISK IN NON-HYPERTENSIVE MIDDLE-AGED AND OLDER AMERICAN MEN Article Open access 24

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1996;16:1509–15. Article  CAS  Google Scholar  Download references AUTHOR INFORMATION Author notes * These authors contributed equally: Teemu J. Murtola, Tatu V. J. Kasurinen. AUTHORS AND

AFFILIATIONS * Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland Teemu J. Murtola, Tatu V. J. Kasurinen & Teuvo L. J. Tammela * Department of Urology,

Tampere University Hospital, Tampere, Finland Teemu J. Murtola & Teuvo L. J. Tammela * Finnish Cancer Registry, Helsinki, Finland Kirsi Talala * Department of Urology, University of

Helsinki and Helsinki University Hospital, Helsinki, Finland Kimmo Taari * Faculty of Social Sciences, University of Tampere, Tampere, Finland Anssi Auvinen Authors * Teemu J. Murtola View

author publications You can also search for this author inPubMed Google Scholar * Tatu V. J. Kasurinen View author publications You can also search for this author inPubMed Google Scholar *

Kirsi Talala View author publications You can also search for this author inPubMed Google Scholar * Kimmo Taari View author publications You can also search for this author inPubMed Google

Scholar * Teuvo L. J. Tammela View author publications You can also search for this author inPubMed Google Scholar * Anssi Auvinen View author publications You can also search for this

author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Teemu J. Murtola. ETHICS DECLARATIONS CONFLICT OF INTEREST The manuscript was supported by a competitive research grant

from the Expert Responsibility Area of The Pirkanmaa Hospital District to TJM. Dr. TJM has worked as a paid consultant for Astellas and Janssen-Cilag and received lecture fees from Astellas,

Janssen-Cilag, Abbvie and MSD. Dr. KT has received consulting fees from Abbvie, research funding from Medivation, and travel support from Astellas, and Orion. Professor TLJT has worked as a

paid consultant for Astellas and Janssen-Cilag, and received lecture fees from Astellas, Janssen-Cilag, Abbvie and MSD. Professor AA has received a lecture fee from MSD, and worked as a

paid consultant for Epid Research Inc. The remaining authors declare that they have no conflict of interest. ELECTRONIC SUPPLEMENTARY MATERIAL SUPPLEMENTARY TABLE 1 SUPPLEMENTARY TABLE 2

SUPPLEMENTARY TABLE 3 SUPPLEMENTARY TABLE 4 RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Murtola, T.J., Kasurinen, T.V.J., Talala, K. _et al._ Serum

cholesterol and prostate cancer risk in the Finnish randomized study of screening for prostate cancer. _Prostate Cancer Prostatic Dis_ 22, 66–76 (2019).

https://doi.org/10.1038/s41391-018-0087-0 Download citation * Received: 31 January 2018 * Revised: 26 April 2018 * Accepted: 16 May 2018 * Published: 13 September 2018 * Issue Date: March

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