ENDOMETRIAL CANCER RISK IN RELATION TO SERUM-LIPIDS AND LIPOPROTEIN LEVELS

Blood lipids are useful biochemical indicators for assessing the risk of a number of chronic diseases, particularly those associated with ob esity. In a multicenter case-control study that included 256 cases and 185 controls less than 75 years old, we studied the risk of endometri al cancer in relation to serum cholesterol, low density lipoprotein ch olesterol, high density lipoprotein cholesterol, and triglycerides. Co ntrary to expectation, blood lipids were, in general, lower among case s compared with controls. The effects of low blood lipids, specificall y cholesterol and low density lipoprotein cholesterol, were limited to older women (greater than or equal to 55 years). Risk of the disease in this subgroup of 177 cases and 110 controls was increased 3-4-fold among those with the lowest cholesterol or low density lipoprotein cho lesterol values. For example, after adjustment for age, education, smo king status, obesity, and body fat distribution, the relative risks of endometrial cancer across decreasing quartiles of serum cholesterol w ere 1.0, 2.5, 2.4, and 4.2 (P for trend < 0.01). We examined blood lip id levels by disease stage. The low lipid values of older cases did no t appear to be a consequence of the disease. While we cannot rule out the possibility that hypocholesterolemia is a predisposing factor for endometrial cancer, there is no obvious biological explanation for the inverse association.