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Low Cholesterol May Reduce Risk For High-grade Prostate Cancer

Men with lower cholesterol are less likely than those with higher levels to develop high-grade prostate cancer, an aggressive form of the disease with a poorer prognosis, according to results of an important Johns Hopkins collaborative study.

In a prospective study of more than 5,000 U.S. men, epidemiologists say they now have evidence that having lower levels of heart-clogging fat may cut a man's risk of this form of cancer by nearly 60 percent.

"For many reasons, we know that it's good to have a cholesterol level within the normal range. Now, we have more evidence that among the benefits of low cholesterol may be a lower risk for potentially deadly prostate cancers." reported the researchers.

As a reference, the normal range is defined as less than 200 mg/dL (milligrams per deciliter of blood) of total cholesterol.

The researchers found similar results in a study first published in 2008, and in 2006, they linked use of cholesterol-lowering statin drugs to lower risk of advanced prostate cancer.

For the current study, researchers from the Southwest Oncology Group and other collaborators analyzed data from 5,586 men aged 55 and older enrolled in the Prostate Cancer Prevention Trial from 1993 to 1996. Some 1,251 men were diagnosed with prostate cancer during the study period.

Men with cholesterol levels lower than 200 mg/dL had a 59 percent lower risk of developing high-grade prostate cancers, which tend to grow and spread rapidly. High-grade cancers are identified by a pathological ranking called the Gleason score. Scores at the highest end of the scale, between eight and 10, indicate cancers considered the most worrisome to pathologists who examine samples of the diseased prostate under the microscope.

In this new study, cholesterol levels had no significant effect on the entire spectrum of prostate cancer incidence, only those that were high-grade.

While the team took into account factors that could bias the results, such as smoking history, weight, family history of prostate cancer, and dietary cholesterol, other things could have affected their results. One example is whether men in the study were taking cholesterol- lowering drugs at the time of the blood collections, a data point the researchers expect to analyze soon.

Results of the current study are expected to be published online this month in the Journal Cancer Epidemiology, Biomarkers & Prevention. Also in the journal is an accompanying paper from the National Cancer Institute showing that lower cholesterol in men conferred a 15 percent decrease in overall cancer cases.

"Cholesterol may affect cancer cells at a level where it influences key signaling pathways controlling cell survival. Cancer cells use these survival pathways to evade the normal cycle of cell life and death." explained the researchers.

Targeting cholesterol metabolism may be one route to treating and preventing the disease, but this remains to be tested.

Funding for the study was provided by the National Cancer Institute


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