Lipid biomarkers and long-term risk of cancer in the Women's Health Study

Abstract

Background: Lipid biomarkers, such as HDL-cholesterol concentra tions, have been shown to have positive, inverse, and null association with total, breast, and colorectal cancer risks. Studies of novel lipi biomarkers, such as apolipoprotein A-I (apo A-I) and apolipoprotein B 100 (apo B-100), and cancer risk have been sparse, to our knowledg Objectives: We evaluated the prospective association of total, breas colorectal, and lung cancers and cancer mortality with circulating lipi biomarkers in 15,602 female health professionals in the Women's Healt Study (aged $45 y, free of cardiovascular disease and cancer, and witho hormone replacement therapy or lipid-lowering medications at baseline Design: Cox regression models estimated HRs of cancer endpoin (19 y median follow-up) across quartiles 1 (reference) to 4 of eac lipid biomarker after adjustment for cancer risk factors. Results: Confirmed cases included 2163 incident cancer cases (86 breast, 198 colorectal, and 190 lung cancers) and 647 cancer death Total cancer risk was significantly lower in the highest quartile of ap A-I (adjusted HR: 0.79; 95% CI: 0.70, 0.90; P-trend = 0.0008) an HDL cholesterol (HR: 0.85; 95% CI: 0.75, 0.97; P-trend = 0.01). Fo site-specific cancers, significant associations included colorectal cance risk with HDL cholesterol (HR: 0.63; 95% CI; 0.41, 0.98; P-trend 0.03), triglycerides (HR: 1.86; 95% CI: 1.17, 2.97; P-trend = 0.02), an apo B-100 (HR: 1.60; 95% CI: 1.03, 2.49; P-trend = 0.006) and lun cancer risk with HDL cholesterol (HR: 0.59; 95% CI: 0.38, 0.93; P trend = 0.01). LDL cholesterol was not significantly associated wit risk of total cancer or any site-specific cancers. In time-depende models that were adjusted for the use of a lipid-lowering medicatio after baseline, these associations remained. Conclusions: Lipids were associated with total, lung, and colorect cancer risks in women. Lifestyle interventions for heart-disease pr vention, which reduce apo B-100 or raise HDL cholesterol, may b associated with reduced cancer risk. The Women's Health Study wa registered at clinicaltrials.gov as NCT00000479.