Association between hypercholesterolemia and risk of cancer: Age and gender differences

Background: Metabolic risk factors, such as obesity and diabetes, have been implicated in cancer incidence. However, the effect of hypercholesterolemia (high total cholesterol) on cancer incidence remains inconclusive. This study evaluates age and gender differences in the association between hypercholesterolemia and cancer risk. Methods: Data are derived from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. This prospective cohort study examines 8,338 women and 5,703 men, aged 25-74 years and cancer-free at baseline, followed from 1971-75 until 1992. Adhering to guidelines in the Adult Treatment Panel III Report, 200 mg/dL was used as the cut-off for total cholesterol. Data were analyzed using multivariable hierarchical logistic regression analysis. Results: In the unadjusted analysis, hypercholesterolemia was associated with elevated cancer risk (Odds Ratio or OR: 1.36; 95% Confidence Interval or CI: 1.13-1.64). Stratifying by gender, OR of 1.50 (CI: 1.17 – 1.92) suggested that women with high cholesterol were 1.5 times more likely to develop cancer than women with low cholesterol. The association between cholesterol and cancer in women remained positive after controlling for race, income, and education (OR: 1.51; CI: 1.17 – 1.94). Stratifying by age, and controlling for demographics, the association between cholesterol and cancer risk was positive for persons under 50 years of age (OR: 1.33; CI: 1.002 – 1.760). Conclusion: Hypercholesterolemia may be a significant risk factor for cancer, with the biologic mechanism functioning differentially by gender and age. Results indicate that the association between cholesterol and cancer risk is greater among women and persons younger than 50.