Low Plasma Cholesterol Predicts an Increased Risk of Lung-Cancer in Elderly Women

Background. There have been significant efforts in the United States to lower high cholesterol levels. Studies of men, however, have found a higher total cancer mortality rate at lower levels of plasma cholesterol. Many of these studies have found that lung cancer is more closely associated than other cancers with low cholesterol. Of the studies that include women, none has demonstrated a statistically significant inverse association between low cholesterol and lung cancer. Methods. We examined the relation between very low plasma cholesterol levels (<160 mg/dl) and lung cancer death in an 18-year prospective study of 2,011 men and 2,327 women. Results. After adjusting for age, body mass index, smoking, and education, the relative hazard of lung cancer mortality for those with low cholesterol (<160 mg/dl) compared with all other cholesterol levels (≥ 160 mg/dl) was 1.75 among men (P = 0.28) and 3.29 among women (P = 0.02). Excluding those who died within 5 years of baseline did not change the results. Conclusions. Both men and women with baseline plasma cholesterol levels <160 mg/dl were more likely to die of lung cancer. This difference was statistically significant in women. The association could not be explained by occult malignancy, smoking, or socioeconomic status.