Declining serum cholesterol levels prior to diagnosis of colon cancer. A time-trend, case-control study
S. J. Winawer, B. J. Flehinger, J. Buchalter, E. Herbert and M. Shike
Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
We report the results of a 10-year, time-trend, case-control study in which
serum cholesterol level was determined at several points in time preceding
the diagnosis of colon cancer in a population of individuals who sought
general checkups at an ambulatory care screening facility. Each of the 69
patients with colon cancer (32 men and 37 women) was matched with a control
patient who was randomly selected. At the time of diagnosis, the patients
with colon cancer had significantly lower serum cholesterol values than
control patients (5.56 +/- 0.31 mmol/L [SEM] vs 6.47 +/- 0.34 mmol/L). This
difference did not vary with sex or Dukes' stage of the cancer. The percent
of matched pairs in which the cancer patient had a lower serum cholesterol
level increased from 42% at 10 years prior to cancer diagnosis to 77% at
diagnosis. The ratio of serum cholesterol at each period to the level at
time of diagnosis demonstrated an average decline of 13% during the 10
years prior to diagnosis for case patients vs an average rise of 2% in the
same period for control patients. We conclude that individuals in whom
colorectal cancer develops share the same level of serum cholesterol as the
general population initially, but during the 10 years preceding the cancer
demonstrate a decline in serum cholesterol level that is opposite to the
rising level seen with age in the general population.
