Impact of serum total cholesterol on the incidence of gastric cancer in a population-based prospective study: The Hisayama study

Kouichi Asano, Michiaki Kubo, Koji Yonemoto, Yasufumi Doi, Toshiharu Ninomiya, Yumihiro Tanizaki, Hisatomi Arima, Tomoko Shirota, Takayuki Matsumoto, Mitsuo Iida, Yutaka Kiyohara

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Abstract

The results of prospective studies that have examined the association between serum cholesterol levels and the incidence of gastric cancer remain controversial. To examine this issue in a general population, a total of 2,604 subjects aged 40 years or older were followed up prospectively for 14 years. During the follow-up period, gastric cancer developed in 97 subjects. The age- and sex-adjusted incidence of gastric cancer by quartiles of serum cholesterol level, namely, <4.06, 4.06-5.32, 5.33-6.04 and ≥6.05 mmol/L, were 3.9, 3.3, 3.1 and 2.1 per 1,000 person-years, respectively. The risk of gastric cancer increased with decreasing cholesterol level (age- and sex-adjusted hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.01-1.49; p = 0.04 for a decrease of 1 mmol/L in serum cholesterol level). This inverse association remained unchanged even after adjustment for other confounding factors, namely, Helicobacter pylori infection, atrophic gastritis, family history of malignant neoplasm, smoking habits, body mass index, hemoglobin A1c, white blood cell count and dietary factors (adjusted HR, 1.28; 95% CI, 1.03-1.58; p = 0.02). This association was significant for intestinal-type gastric cancers, but not for diffuse-type. As regards cancer stage, the inverse cholesterol-cancer association was marginally significant for early gastric cancer after multivariate-adjustment (adjusted HR, 1.25; 95% CI, 0.97-1.61; p = 0.09), but was not for advanced gastric cancer probably due to the small number of cases. In conclusion, our findings suggest that low serum cholesterol levels are an independent risk factor for developing gastric cancer, especially intestinal-type gastric cancer.

Original languageEnglish
Pages (from-to)909-914
Number of pages6
JournalInternational Journal of Cancer
Volume122
Issue number4
DOIs
Publication statusPublished - 15-02-2008

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Stomach Neoplasms
Cholesterol
Prospective Studies
Incidence
Serum
Population
Intestinal Neoplasms
Confidence Intervals
Social Adjustment
Atrophic Gastritis
Neoplasms
Helicobacter Infections
Leukocyte Count
Helicobacter pylori
Habits
Hemoglobins
Body Mass Index
Smoking

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Asano, Kouichi ; Kubo, Michiaki ; Yonemoto, Koji ; Doi, Yasufumi ; Ninomiya, Toshiharu ; Tanizaki, Yumihiro ; Arima, Hisatomi ; Shirota, Tomoko ; Matsumoto, Takayuki ; Iida, Mitsuo ; Kiyohara, Yutaka. / Impact of serum total cholesterol on the incidence of gastric cancer in a population-based prospective study : The Hisayama study. In: International Journal of Cancer. 2008 ; Vol. 122, No. 4. pp. 909-914.
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abstract = "The results of prospective studies that have examined the association between serum cholesterol levels and the incidence of gastric cancer remain controversial. To examine this issue in a general population, a total of 2,604 subjects aged 40 years or older were followed up prospectively for 14 years. During the follow-up period, gastric cancer developed in 97 subjects. The age- and sex-adjusted incidence of gastric cancer by quartiles of serum cholesterol level, namely, <4.06, 4.06-5.32, 5.33-6.04 and ≥6.05 mmol/L, were 3.9, 3.3, 3.1 and 2.1 per 1,000 person-years, respectively. The risk of gastric cancer increased with decreasing cholesterol level (age- and sex-adjusted hazard ratio [HR], 1.22; 95{\%} confidence interval [CI], 1.01-1.49; p = 0.04 for a decrease of 1 mmol/L in serum cholesterol level). This inverse association remained unchanged even after adjustment for other confounding factors, namely, Helicobacter pylori infection, atrophic gastritis, family history of malignant neoplasm, smoking habits, body mass index, hemoglobin A1c, white blood cell count and dietary factors (adjusted HR, 1.28; 95{\%} CI, 1.03-1.58; p = 0.02). This association was significant for intestinal-type gastric cancers, but not for diffuse-type. As regards cancer stage, the inverse cholesterol-cancer association was marginally significant for early gastric cancer after multivariate-adjustment (adjusted HR, 1.25; 95{\%} CI, 0.97-1.61; p = 0.09), but was not for advanced gastric cancer probably due to the small number of cases. In conclusion, our findings suggest that low serum cholesterol levels are an independent risk factor for developing gastric cancer, especially intestinal-type gastric cancer.",
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Asano, K, Kubo, M, Yonemoto, K, Doi, Y, Ninomiya, T, Tanizaki, Y, Arima, H, Shirota, T, Matsumoto, T, Iida, M & Kiyohara, Y 2008, 'Impact of serum total cholesterol on the incidence of gastric cancer in a population-based prospective study: The Hisayama study', International Journal of Cancer, vol. 122, no. 4, pp. 909-914. https://doi.org/10.1002/ijc.23191

Impact of serum total cholesterol on the incidence of gastric cancer in a population-based prospective study : The Hisayama study. / Asano, Kouichi; Kubo, Michiaki; Yonemoto, Koji; Doi, Yasufumi; Ninomiya, Toshiharu; Tanizaki, Yumihiro; Arima, Hisatomi; Shirota, Tomoko; Matsumoto, Takayuki; Iida, Mitsuo; Kiyohara, Yutaka.

In: International Journal of Cancer, Vol. 122, No. 4, 15.02.2008, p. 909-914.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of serum total cholesterol on the incidence of gastric cancer in a population-based prospective study

T2 - The Hisayama study

AU - Asano, Kouichi

AU - Kubo, Michiaki

AU - Yonemoto, Koji

AU - Doi, Yasufumi

AU - Ninomiya, Toshiharu

AU - Tanizaki, Yumihiro

AU - Arima, Hisatomi

AU - Shirota, Tomoko

AU - Matsumoto, Takayuki

AU - Iida, Mitsuo

AU - Kiyohara, Yutaka

PY - 2008/2/15

Y1 - 2008/2/15

N2 - The results of prospective studies that have examined the association between serum cholesterol levels and the incidence of gastric cancer remain controversial. To examine this issue in a general population, a total of 2,604 subjects aged 40 years or older were followed up prospectively for 14 years. During the follow-up period, gastric cancer developed in 97 subjects. The age- and sex-adjusted incidence of gastric cancer by quartiles of serum cholesterol level, namely, <4.06, 4.06-5.32, 5.33-6.04 and ≥6.05 mmol/L, were 3.9, 3.3, 3.1 and 2.1 per 1,000 person-years, respectively. The risk of gastric cancer increased with decreasing cholesterol level (age- and sex-adjusted hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.01-1.49; p = 0.04 for a decrease of 1 mmol/L in serum cholesterol level). This inverse association remained unchanged even after adjustment for other confounding factors, namely, Helicobacter pylori infection, atrophic gastritis, family history of malignant neoplasm, smoking habits, body mass index, hemoglobin A1c, white blood cell count and dietary factors (adjusted HR, 1.28; 95% CI, 1.03-1.58; p = 0.02). This association was significant for intestinal-type gastric cancers, but not for diffuse-type. As regards cancer stage, the inverse cholesterol-cancer association was marginally significant for early gastric cancer after multivariate-adjustment (adjusted HR, 1.25; 95% CI, 0.97-1.61; p = 0.09), but was not for advanced gastric cancer probably due to the small number of cases. In conclusion, our findings suggest that low serum cholesterol levels are an independent risk factor for developing gastric cancer, especially intestinal-type gastric cancer.

AB - The results of prospective studies that have examined the association between serum cholesterol levels and the incidence of gastric cancer remain controversial. To examine this issue in a general population, a total of 2,604 subjects aged 40 years or older were followed up prospectively for 14 years. During the follow-up period, gastric cancer developed in 97 subjects. The age- and sex-adjusted incidence of gastric cancer by quartiles of serum cholesterol level, namely, <4.06, 4.06-5.32, 5.33-6.04 and ≥6.05 mmol/L, were 3.9, 3.3, 3.1 and 2.1 per 1,000 person-years, respectively. The risk of gastric cancer increased with decreasing cholesterol level (age- and sex-adjusted hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.01-1.49; p = 0.04 for a decrease of 1 mmol/L in serum cholesterol level). This inverse association remained unchanged even after adjustment for other confounding factors, namely, Helicobacter pylori infection, atrophic gastritis, family history of malignant neoplasm, smoking habits, body mass index, hemoglobin A1c, white blood cell count and dietary factors (adjusted HR, 1.28; 95% CI, 1.03-1.58; p = 0.02). This association was significant for intestinal-type gastric cancers, but not for diffuse-type. As regards cancer stage, the inverse cholesterol-cancer association was marginally significant for early gastric cancer after multivariate-adjustment (adjusted HR, 1.25; 95% CI, 0.97-1.61; p = 0.09), but was not for advanced gastric cancer probably due to the small number of cases. In conclusion, our findings suggest that low serum cholesterol levels are an independent risk factor for developing gastric cancer, especially intestinal-type gastric cancer.

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