{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:07:26Z","timestamp":1767676046886,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1UM1CA173642"],"award-info":[{"award-number":["1UM1CA173642"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Published studies have demonstrated inconclusive relationships between serum lipid levels and mortality after cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The primary objective was to evaluate the relationship between fasting lipid levels and mortality after cancer. Data were obtained on baseline lipids and outcomes after cancer from 1263 postmenopausal women diagnosed with 13 obesity\u2010related cancers who were part of the Women's Health Initiative (WHI) lipid biomarkers cohort. Obesity\u2010related cancers included incident invasive cancers of the breast, colorectum, endometrium, esophagus (adenocarcinoma), kidney, liver, gallbladder, pancreas, ovaries, small intestine, thyroid, stomach, as well as multiple myeloma. Baseline lipid measurements included high\u2010density lipoprotein (HDL)\u2010cholesterol, low\u2010density lipoprotein (LDL)\u2010cholesterol, and non\u2010HDL\u2010cholesterol. Outcomes were all cause, cancer\u2010specific, and CVD mortality. Multivariable Cox proportional hazards models were used to measure associations between lipid levels and mortality (all cause, cancer, and CVD) after a cancer diagnosis, with lipids analyzed as continuous variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among women with obesity\u2010related cancer, there were 707 deaths, of which 379 (54%) were due to cancer and 113 (16%) were due to CVD. Mean time from blood draw to cancer diagnosis was 5.1\u2009years (range: 0.05\u201310\u2009years). LDL\u2010C values above the 95th percentile were associated with higher risk of all\u2010cause mortality (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and cancer\u2010specific mortality (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), but not mortality due to CVD. Non\u2010HDL\u2010C values above the 65th percentile were associated with higher risk of all\u2010cause mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) and mortality due to CVD (<jats:italic>p<\/jats:italic>\u2009=\u20090.003), but not cancer\u2010specific mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.37). HDL\u2010C values above the 95th percentile were associated with lower all\u2010cause mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.002), and above the 65th percentile with lower cancer\u2010specific mortality (<jats:italic>p<\/jats:italic>\u2009=\u20090.003), but no significant relationship with mortality due to CVD was observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The relationship between pre\u2010diagnosis fasting lipid levels and mortality after cancer diagnosis is complex. These results suggest that improved lipid control through lifestyle and anti\u2010lipid medications could have a meaningful impact on outcomes after cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6266","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T08:54:27Z","timestamp":1688028867000},"page":"16626-16636","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pre\u2010diagnosis lipid levels and mortality after obesity\u2010related cancer diagnosis in the Women's Health Initiative cardiovascular disease biomarker cohort"],"prefix":"10.1002","volume":"12","author":[{"given":"Gayane","family":"Hovsepyan","sequence":"first","affiliation":[{"name":"Wayne State University School of Medicine  Detroit Michigan USA"},{"name":"Scripps Green Internal Medicine Residency Program  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Barac","sequence":"additional","affiliation":[{"name":"Georgetown University  Washington District of Columbia USA"},{"name":"Inova Heart and Vascular Institute  Falls Church Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7781-609X","authenticated-orcid":false,"given":"Theodore M.","family":"Brasky","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center Ohio State University  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aladdin H.","family":"Shadyab","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Public Health and Human Longevity Science University of California, San Diego  La Jolla California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Lehman","sequence":"additional","affiliation":[{"name":"Center for Biostatistics Ohio State University  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric M.","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Center for Biostatistics Ohio State University  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazmus","family":"Saquib","sequence":"additional","affiliation":[{"name":"College of Medicine Sulaiman AlRajhi University  Al Bukayriyah Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil M.","family":"Iyengar","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Wild","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center  Oklahoma City Oklahoma USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bette J.","family":"Caan","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Medical Program of Northern California  Oakland California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9816-7284","authenticated-orcid":false,"given":"Pinkal","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Oncology Weill Cornell Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4320-739X","authenticated-orcid":false,"given":"Jennifer","family":"Beebe\u00a0Dimmer","sequence":"additional","affiliation":[{"name":"Wayne State University School of Medicine  Detroit Michigan USA"},{"name":"Department of Oncology Barbara Ann Karmanos Cancer Institute at Wayne Sate University  Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia A.","family":"Thomson","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences Mel &amp; 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