Abstract 857: High-Density Lipoprotein Cholesterol Levels Are Inversely Associated With Cancer Risk
Background: Epidemiologic data demonstrate an inverse relationship between serum cholesterol levels and incident cancer. We recently reported that lower levels of low-density lipoprotein cholesterol (LDL-C) are associated with a significantly higher risk of incident cancer in a meta-analysis of large randomized controlled trials (RCTs) of statin therapy. To date, no analysis has examined the relationship of high-density lipoprotein cholesterol (HDL-C) and cancer risk. Therefore, we sought to study the association of HDL-C and the risk of incident cancer in large RCTs of lipid-altering interventions.
Methods: A systematic MEDLINE search identified lipid intervention RCTs with ≥1,000 person-years of follow-up, providing baseline HDL-C levels and rates of incident cancer. Random-effects meta-regressions evaluated the relationship between baseline HDL-C and incident cancer in each RCT arm.
Results: A total of 21 eligible RCTs were identified (25 pharmacologic intervention arms, and 20 control arms), with 586,528 person-years of follow-up, and 7,928 incident cancers, over a median follow-up of 5 years (interquartile range 2.9 –5.1). There was a significant inverse association between baseline HDL-C levels and the rate of incident cancer (p=0.05). The inverse association persisted after adjusting for baseline LDL-C, age, body-mass index (BMI) and smoking status such that for every 10mg/dl increment in HDL-C, there was a 21% (95% CI: 8%–33%) relative reduction in the rate of incident cancer (p=0.004).
Conclusion: There is a significant inverse association between HDL-C and the risk of incident cancer, which is independent of LDL-C, age, BMI and smoking status. The etiologic basis and clinical implications of the observed inverse association between HDL-C and cancer will require further research.