Blood lipid and lipoprotein concentrations and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition

Fränzel J B Van Duijnhoven, H. Bas Bueno-De-Mesquita, Miriam Calligaro, Mazda Jenab, Tobias Pischon, Eugène H J M Jansen, Jiri Frohlich, Amir Ayyobi, Kim Overvad, Anne Pernille Toft-Petersen, Anne Tjønneland, Louise Hansen, Marie Christine Boutron-Ruault, Françoise Clavel-Chapelon, Vanessa Cottet, Domenico Palli, Giovanna Tagliabue, Salvatore Panico, Rosario Tumino, Paolo VineisRudolf Kaaks, Birgit Teucher, Heiner Boeing, Dagmar Drogan, Antonia Trichopoulou, Pagona Lagiou, Vardis Dilis, Petra H M Peeters, Peter D. Siersema, Laudina Rodríguez, Carlos A. González, Esther Molina-Montes, Miren Dorronsoro, Maria Jose Tormo, Aurelio Barricarte, Richard Palmqvist, Göran Hallmans, Kay Tee Khaw, Kostas K. Tsilidis, Francesca L. Crowe, Veronique Chajes, Veronika Fedirko, Sabina Rinaldi, Teresa Norat, Elio Riboli

Research output: Contribution to journalArticlepeer-review


Objective: To examine the association between serum concentrations of total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol, triglycerides, apolipoprotein A-I (apoA), apolipoprotein B and the incidence of colorectal cancer (CRC). Design: Nested case-control study. Setting: The study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort of more than 520 000 participants from 10 western European countries. Participants: 1238 cases of incident CRC, which developed after enrolment into the cohort, were matched with 1238 controls for age, sex, centre, followup time, time of blood collection and fasting status. Main outcome measures: Serum concentrations were quantitatively determined by colorimetric and turbidimetric methods. Dietary and lifestyle data were obtained from questionnaires. Conditional logistic regression models were used to estimate incidence rate ratios (RRs) and 95% CIs which were adjusted for height, weight, smoking habits, physical activity, education, consumption of fruit, vegetables, meat, fish, alcohol, fibre and energy. Results: After adjustments, the concentrations of HDL and apoA were inversely associated with the risk of colon cancer (RR for 1 SD increase of 16.6 mg/dl in HDL and 32.0 mg/dl in apoA of 0.78 (95% CI 0.68 to 0.89) and 0.82 (95% CI 0.72 to 0.94), respectively). No association was observed with the risk of rectal cancer. Additional adjustment for biomarkers of systemic inflammation, insulin resistance and oxidative stress or exclusion of the first 2 years of follow-up did not influence the association between HDL and risk of colon cancer. Conclusions: These findings show that high concentrations of serum HDL are associated with a decreased risk of colon cancer. The mechanism behind this association needs further elucidation.

Original languageEnglish
Pages (from-to)1094-1102
Number of pages9
Issue number8
Publication statusPublished - Aug 2011

ASJC Scopus subject areas

  • Gastroenterology


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