Cholesterol Levels in Blood and the Risk of Prostate Cancer: A Meta-analysis of 14 Prospective Studies

Background:As a neutral lipid and prominent component of the Western diet, cholesterol levels might be a risk factor for prostate cancer (PCa). However, current evidence has been inconsistent. This meta-analysis aimed to evaluate the association between blood cholesterol levels and the risk of PCa. Methods:An extensive search was performed in MEDLINE and EMBASE for prospective studies that have reported the association between total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) levels in blood and risk of PCa. Random-effects models were used to summarize the study-specific results. Results:Fourteen studies were included in this meta-analysis. In the meta-analysis, the summarized RRs for the highest to lowest cholesterol levels were as follows: 1.05 (95% CI: 0.97-1.14; P = 0.21) for TC, 0.93 (95% CI: 0.80-1.10, P = 0.40) for HDL, and 1.17 (95% CI: 0.88-1.55, P = 0.51) for LDL. When restricting to high-grade PCa, the pooled RR was 1.32 (95% CI: 0.93-1.87, P = 0.13) for TC. In dose-response analyses, a 1 mmol/l increment in blood TC, HDL, and LDL level conferred a RR of 1. 01 (95% CI: 0.99-1.02; P = 0.38), 0.98 (95% CI: 0.91- 1.07; P = 0.72) and 1.04 (95% CI: 0.98-1.10; P = 0.24), respectively. Conclusions: In this meta-analysis of 14 large prospective studies, blood TC, HDL, and LDL levels were not associated with the risk of either overall PCa or high-grade PCa. Impact:Our findings did not appear to support the hypothesis that hypercholesterolemia increases the risk of PCa.