|The following article is part of conference coverage from the 2017 American Urological Association meeting in Boston. Renal and Urology News’ staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2017.|
BOSTON—Elevated cholesterol levels are associated with an increased risk of high-grade prostate cancer (PCa), investigators reported at the American Urological Association 2017 annual meeting.
The study, by Juzar Jamnagerwalla, MD, a chief resident at Cedars-Sinai Medical Center in Los Angeles and colleagues, included 4904 men who participated in the 4-year REDUCE (Reduction by Dutasteride of Prostate Cancer Events) study and were not taking statins. As part of the study protocol, patients were required to undergo study-mandated biopsies. Each 10 mg/dL increase in total cholesterol was significantly associated with 23% greater odds of high-grade PCa (Gleason score 7 or higher) at the 2-year biopsy. Total cholesterol levels were not associated with overall and low-grade PCa risk.
In addition, each 10 mg/dL increase in high-density lipoprotein (HDL) levels was significantly associated with 34% and 74% greater odds of overall and high-grade PCa, respectively. The investigators found no association between low-density lipoprotein levels and PCa risk.
“Epidemiological studies linking cholesterol to prostate cancer are mixed. However, results may be biased as cholesterol has been shown to be associated with PSA, thus influencing biopsy rates,” Dr. Jamnagerwalla told Renal & Urology News. “Given this, we tested the association between serum lipids and prostate cancer in the REDUCE study, in which all men received study- mandated biopsies, finding that both HDL and total cholesterol were associated with significant increases in the risk of high-grade prostate cancer.”
“There is a lot of interest in how cholesterol relates to prostate cancer risk,” said senior author Stephen J. Freedland, MD, Professor of Surgery at Cedars-Sinai, where he also serves as Associate Director for Faculty Development in the Samuel Oschin Comprehensive Cancer Institute. “We found that higher cholesterol was linked selectively with high-grade prostate cancer. This mirrors the data [showing] that statins may have little effect on overall prostate cancer risk, but reduce the risk of aggressive prostate cancer. This study provides further support for research testing whether lowering cholesterol can prevent and/or treat aggressive prostate cancer as well as to understand the mechanisms through which this occurs.”
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Jamnagerwalla J, Howard LE, Vidal AC, et al. Higher cholesterol is linked with increased risk of high-grade prostate cancer: Results from the REDUCE study. [abstract[. J Urol 2017;197(4S):e163. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 12. MP14-03