Researchers have demonstrated a link between high cholesterol and an increased risk of high-grade prostate cancer, according to a study published in Cancer Epidemiology, Biomarkers & Prevention (2009;15:2807-2813).

In a study led by Elizabeth Platz, ScD, MPH, of Johns Hopkins Bloomberg School of Public Health, when 5,586 men who were 55 years or older were randomized to the placebo arm of the Prostate Cancer Prevention Trial (PCPT), men whose cholesterol levels were below 200 mg/dL had a 59% decreased risk of Gleason 8-10 prostate cancer compared with men who had higher cholesterol levels. “Our findings add to the literature supporting a role for cholesterol in the etiology of prostate cancer with worse prognosis,” the authors wrote.

For the PCPT, which was initiated in 1993, researchers randomized subjects to receive 5 mg/day of finasteride or placebo for 7 years to investigate the role that finasteride played in the prevention of prostate cancer. The study found that finasteride treatment was associated with a 25% decreased incidence of prostate cancer.

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According to the press release announcing the findings, previous studies have suggested that statin use may protect against advanced prostate cancer. One study, published in the Journal of the National Cancer Institute (2006;98:1819-1825), revealed that statin use was associated with a 43% decreased risk of advanced prostate cancer and a 65% decreased risk of fatal or metastatic prostate cancer.

Stephen Freeland, MD, a prostate cancer researcher from the Duke Prostate Center at Duke University Medical Center explained that cholesterol also many directly stimulate tumor growth. “Lower cholesterol means it is harder for the cells to replicate,” Dr Freeland stated. “Given that high-grade tumors grow faster, this could explain why low cholesterol only reduced the risk of high-grade disease. All of these mechanisms suggest that it is indeed plausible that high cholesterol could promote more aggressive cancers.”