Dataset Information

Serum cholesterol and risk of high-grade prostate cancer: results from the REDUCE study.

ABSTRACT: BACKGROUND:Epidemiologic evidence for a serum cholesterol-prostate cancer link is mixed. Prostate-specific antigen (PSA) is positively correlated with cholesterol, potentially increasing PSA-driven biopsy recommendations in men with high cholesterol, though biopsy compliance may be lower in men with comorbid conditions. These potential biases may affect PSA-driven biopsy rates and subsequent prostate cancer detection in men with high serum cholesterol. Our objective was to test the association between serum cholesterol and prostate cancer risk in men receiving PSA independent, study-mandated prostate biopsies. METHODS:We conducted a post hoc analysis of data from 4974 non-statin users in REDUCE, a randomized trial in men with elevated PSA and a negative baseline biopsy. Men underwent 2- and 4-year trial-mandated prostate biopsies. Associations between baseline serum levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and prostate cancer risk, overall and by Gleason grade (<7 vs. ?7), were examined using multivariable logistic regression. RESULTS:High total serum cholesterol was associated with an increased risk of high-grade prostate cancer diagnosis (OR per 10?mg/dL 1.05; 95% CI 1.00-1.09; p?=?0.048), but cholesterol was unrelated to either overall or low-grade prostate cancer risk (p-values >0.185). There was no association between serum LDL and overall, low- or high-grade prostate cancer risk (p-values >0.137). In contrast, elevated serum HDL was associated with increased risk of both overall (OR per 10?mg/dL 1.08; 95% CI 1.01-1.16; p?=?0.033) and high-grade prostate cancer (OR per 10?mg/dL 1.14; 95% CI 1.01-1.28; p?=?0.034). CONCLUSIONS:In REDUCE, where all men received PSA independent, trial-mandated biopsies thus ensuring complete prostate cancer ascertainment, high total serum cholesterol and high HDL were associated with increased risk of high-grade prostate cancer, supporting a cholesterol-prostate cancer link.

SUBMITTER: Jamnagerwalla J

PROVIDER: S-EPMC6021229 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Serum cholesterol and risk of high-grade prostate cancer: results from the REDUCE study.

Jamnagerwalla Juzar J Howard Lauren E LE Allott Emma H EH Vidal Adriana C AC Moreira Daniel M DM Castro-Santamaria Ramiro R Andriole Gerald L GL Freeman Michael R MR Freedland Stephen J SJ

Prostate cancer and prostatic diseases 20171227 2

<h4>Background</h4>Epidemiologic evidence for a serum cholesterol-prostate cancer link is mixed. Prostate-specific antigen (PSA) is positively correlated with cholesterol, potentially increasing PSA-driven biopsy recommendations in men with high cholesterol, though biopsy compliance may be lower in men with comorbid conditions. These potential biases may affect PSA-driven biopsy rates and subsequent prostate cancer detection in men with high serum cholesterol. Our objective was to test the assoc ...[more]

PMID: 29282360

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Project description:PurposeA recent meta-analysis showed that aspirin was associated with reduced prostate cancer risk. As anti-inflammatory medications lower PSA levels, whether these findings reflect reduced prostate cancer detection or lower prostate cancer risk is unknown. We tested the association between aspirin and nonaspirin NSAID use on prostate cancer diagnosis in REDUCE, where all men received biopsies at 2 and 4 years largely independent of PSA. REDUCE tested dutasteride for prostate cancer risk reduction in men with a PSA of 2.5 to 10.0 ng/mL and a negative prestudy biopsy.Experimental designWe examined the association between aspirin, NSAIDs, or both and total, low-grade (Gleason < 7), or high-grade (Gleason ≥ 7) prostate cancer versus no prostate cancer using multinomial logistic regression among 6,390 men who underwent ≥1 on-study biopsy. Multivariable analyses were adjusted for age, race, geographic region, PSA, prostate volume, digital rectal examination, body mass index, treatment arm, smoking, alcohol, statins, hypertension, diabetes, and cardiovascular disease.ResultsOverall, 3,169 men (50%) were nonusers, 1,368 (21%) used aspirin, 1,176 (18%) used NSAIDs, and 677 (11%) used both. In unadjusted models, aspirin was associated with reduced prostate cancer risk (OR = 0.85, P = 0.036). In multivariable analyses, aspirin was associated with reduced total prostate cancer risk (OR = 0.81, P = 0.015). Use of NSAIDs or NSAIDs and aspirin was not associated with total, low-grade, or high-grade prostate cancer, though all ORs were <1 (all P ≥ 0.08). Therefore, we created a dichotomous variable of aspirin and/or NSAID users versus nonusers. On multivariable analysis, the use of aspirin and/or NSAIDs was significantly associated with decreased total (OR = 0.87, P = 0.030) and high-grade (OR = 0.80, P = 0.040), but not with low-grade, prostate cancer risk (OR = 0.90, P = 0.15). Results were similar in placebo and dutasteride arms.ConclusionsAmong men with a negative biopsy, aspirin and/or NSAID use was associated with decreased prostate cancer risk. Additional studies are warranted.

Project description:Obesity is related to an increased risk of gastric cardia cancer. However, the influences of excess body weight and serum total cholesterol on the risk of gastric high-grade dysplasia have not been fully characterized.A case-control study was conducted to explore the relationships between body mass index (BMI), serum total cholesterol level, and the risk of gastric high-grade dysplasia in Chinese adults. A total of 893 consecutive patients with gastric high-grade dysplasia (537 men and 356 women) and 902 controls (543 men and 359 women) were enrolled from January 2000 to October 2015. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, and a multivariate analysis was conducted.After adjusting for age, alcohol consumption, smoking status, family history of gastric cancer or esophageal cancer, and serum total cholesterol level, a BMI ranging from 27.5 to 29.9 was significantly related to an increased risk of gastric high-grade dysplasia in both men (adjusted OR?=?1.87, 95% CI?=?1.24-2.81) and women (adjusted OR?=?2.72, 95% CI?=?1.44-5.16). The 2 highest BMI categories (27.5-29.9 and ?30.0) were identified as risk factors for gastric cardia high-grade dysplasia in both men (BMI?=?27.5-29.9: adjusted OR?=?1.78, 95% CI?=?1.02-3.10; BMI ? 30.0: adjusted OR?=?2.54, 95% CI?=?1.27-5.08) and women (BMI?=?27.5-29.9: adjusted OR?=?2.88, 95% CI?=?1.27-6.55; BMI ? 30.0: adjusted OR?=?2.77, 95% CI?=?1.36-5.64), whereas only a BMI ranging from 27.5 to 29.9 was a risk factor for gastric noncardia high-grade dysplasia in both men (adjusted OR?=?1.98, 95% CI?=?1.25-3.14) and women (adjusted OR?=?2.88, 95% CI?=?1.43-5.81). In addition, higher serum total cholesterol was associated with an increased risk of gastric noncardia high-grade dysplasia (adjusted OR?=?1.83, 95% CI?=?1.25-2.69) in women.Increased BMI was associated with an increased risk of gastric high-grade dysplasia in both men and women, and higher serum total cholesterol increased the risk of gastric noncardia high-grade dysplasia in women.

Dataset Information

Serum cholesterol and risk of high-grade prostate cancer: results from the REDUCE study.

Publications

Serum cholesterol and risk of high-grade prostate cancer: results from the REDUCE study.

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