Total serum cholesterol and cancer mortality in a middle-aged male population

The assessment of total cholesterol level as a risk factor for cancer mortality was studied from data of the Paris Prospective Study of Coronary Heart Disease. A total of 7603 French male government employees aged 43-52 years were followed for an average of 6.6 years. One hunderd and thirty-four cancer deaths were registered with a mean survival time of 4.9 +/- 2.9 years. At entry in the study, future cancer cases were older than survivors and had a lower corpulence index and lower cholesterol value (212 vs 223 mg/100 ml, SD = 43 mg/100 ml) than those of survivors. The intitial cholesterol level did not differ significantly among cancer sites. The mean cholesterol value increased steadily with survival time (p < 0.02) and reached the mean survivors level in men with survival time longer than seven years. Longitudinal cholesterol measurements obtained among 81% of future cancer cases showed a mean decrease, after an average of 3.0 years, comparable to the one estimated from croos-sectional data. The association between low cholesterol and cancer mortality during a period up to seven years before death is not likely to represent an etiologic link but in all probability reflects the advance of the clinical course of cancer.