Is low cholesterol a risk factor for cancer mortality?

Eur J Cancer Prev. 2018 Nov;27(6):570-576. doi: 10.1097/CEJ.0000000000000391.


Although a large number of studies have shown the associations of high plasma lipid profile levels with cancer, few studies demonstrate the association between low serum cholesterol (<160 mg/dl) and risk for cancer mortality. The aim of this study was to determine the association of low serum cholesterol level as a risk factor for mortality in cancer. The prospective cohort studies were conducted on 19 of 52 cohort studies including 30 179 male and 26 005 female participants who were followed up for 9 years. Cox proportion hazard model was applied to analyze these data. The associations are presented as hazard ratios (HRs) with 95% confidence intervals (CI). The statistical package for the social sciences software was used for analysis. The multivariate analysis results showed risk associations with low serum cholesterol for the first decile among male participants (cancer: HR=1.52, 95% CI: 1.06-2.18; noncancer liver dysfunction: HR=10.73, 95% CI: 3.74-30.18) and female participants (cancer: HR=1.03, 95% CI: 0.52-2.05; noncancer liver dysfunction: HR=25.8, 95% CI: 3.09-217.70). Furthermore, in the second decile, this association among male patients (noncancer liver dysfunction: HR=3.73, 95% CI: 1.16-11.95) had a statistically significant result. For the remaining deciles in both sexes, cancer and noncancer liver dysfunction has some risk or protective association, although not significant. Findings of this study indicated an inverse association between low serum cholesterol and cancer and noncancer liver dysfunction mortality.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Cause of Death
  • Cholesterol / blood*
  • Cholesterol / metabolism
  • Female
  • Follow-Up Studies
  • Humans
  • Italy / epidemiology
  • Liver / metabolism
  • Liver / physiopathology*
  • Male
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / mortality*
  • Neoplasms / physiopathology
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Sex Factors
  • Survival Rate
  • Young Adult


  • Cholesterol