Cancer Incidence and Cancer Mortality in Relation to Serum Cholesterol

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Abstract
We studied cancer incidence and mortality from cancer and coronary heart disease in relation to serum cholesterol levels in 92, 710 individuals followed-up in the nationwide Swedish Cancer Register and the Swedish Cause of Death Register for 18–20 years. According to Cox's proportional hazard model, total cancer incidence and total cancer mortality were negatively correlated to serum cholesterol level (P<.001). The negative correlations were most pronounced during the first years of follow-up. Cancer mortality data showed a stronger negative association to cholesterol than did incidence data during the first 10 years of follow-up (P<.05). Mortality from coronary heart disease was positively correlated to serum cholesterol (P<.001) during the entire follow-up. In contrast to most studies that were based on mortality data, our results of the comparison of incidence and mortality data of the same cohort are in agreement with those of a cholesterol-lowering effect of a preclinical cancer. Efforts by investigators and clinicians to lower serum cholesterol to prevent cardiovascular disease are, according to the present findings, not likely to increase cancer mortality risks but would extend life, irrespective of cause of death. [J Natl Cancer Inst 81: 1917–1921, 1989].