Cholesterol and breast cancer risk: a systematic review and meta-analysis of prospective studies

Mathilde Touvier; Philippine Fassier; Mathilde His; Teresa Norat; Doris S.M. Chan; Jacques Blacher; Serge Hercberg; Pilar Galán; Nathalie Druesne‐Pecollo; Paule Latino‐Martel

doi:10.1017/s000711451500183x

Abstract

1 min read

The objective of the present study was to conduct the first systematic review and meta-analysis of prospective studies investigating the associations between total cholesterol (TC), HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) levels and the risk of breast cancer. Relevant studies were identified in PubMed (up to January 2014). Inclusion criteria were original peer-reviewed publications with a prospective design. Random-effects models were used to estimate summary hazard ratios (HR) and 95% CI. Distinction was made between studies that did or did not exclude cancer cases diagnosed during the first years of follow-up, thereby eliminating potential preclinical bias. Overall, the summary HR for the association between TC and breast cancer risk was 0.97 (95% CI 0.94, 1.00; dose-response per 1 mmol/l increment, thirteen studies), and that between HDL-C and breast cancer risk was 0.86 (95% CI 0.69, 1.09; dose-response per 1 mmol/l increment, six studies), with high heterogeneity (I2= 67 and 47%, respectively). For studies that eliminated preclinical bias, an inverse association was observed between the risk of breast cancer and TC (dose-response HR 0.94 (95% CI 0.89, 0.99), seven studies, I2= 78%; highest v. lowest HR 0.82 (95% CI 0.66, 1.02), nine studies, I2= 81%) and HDL-C (dose-response HR 0.81 (95% CI 0.65, 1.02), five studies, I2= 30 %; highest v. lowest HR 0.82 (95% CI 0.69, 0.98), five studies, I2= 0%). There was no association observed between LDL-C and the risk of breast cancer (four studies). The present meta-analysis confirms the evidence of a modest but statistically significant inverse association between TC and more specifically HDL-C and the risk of breast cancer, supported by mechanistic plausibility from experimental studies. Further large prospective studies that adequately control for preclinical bias are needed to confirm the results on the role of cholesterol level and its fractions in the aetiology of breast cancer.

Related publications

Preprint2020

Different Associations between High Density Lipoprotein Cholesterol and Cardiovascular Diseases in Diabetic and Non-diabetic People: A Prospective Community-based Study

Zhijun Wu, Zhe Huang, Alice H. Lichtenstein, Cheng Jin, Shuohua Chen, Frank B Hu, Shouling Wu, Xiang Gao

Article2022

Postdiagnosis recreational physical activity and breast cancer prognosis: Global Cancer Update Programme (<scp>CUP</scp> Global) systematic literature review and meta‐analysis

Margarita Cariolou, Leila Abar, Dagfinn Aune, Katia Balducci, Nerea Becerra‐Tomás, Darren C. Greenwood, Georgios Markozannes, Neesha Nanu, Rita Vieira, Edward L. Giovannucci, Marc J. Gunter, Alan A. Jackson, Ellen Kampman, Vivien Lund, Kate Allen, Nigel T. Brockton, Helen Croker, Daphne Katsikioti, Deirdre McGinley‐Gieser, Panagiota Mitrou, Martin Wiseman, Amanda J. Cross, Elio Riboli, Steven K. Clinton, Anne McTiernan, Teresa Norat, Konstantinos K. Tsilidis, Doris S.M. Chan

Article2018

Tobacco smoking and the risk of atrial fibrillation: A systematic review and meta-analysis of prospective studies

Dagfinn Aune, Sabrina Schlesinger, Teresa Norat, Elio Riboli

Article2020

Physical activity and the risk of abdominal aortic aneurysm: a systematic review and meta-analysis of prospective studies

Dagfinn Aune, Abhijit Sen, Elsa Kobeissi, Mark Hamer, Teresa Norat, Elio Riboli

Article2021

783Lifetime alcohol intake and stomach cancer risk: a pooled analysis of two prospective cohort studies

Harindra Jayasekara, Robert J. MacInnis, Yi Yang, Allison Hodge, Hazel M. Mitchell, Andrew Haydon, Robin Room, John L. Hopper, Marc J. Gunter, Elio Riboli, Graham G. Giles, Roger L. Milne, Dallas R. English, Pietro Ferrari