{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:13:47Z","timestamp":1774368827268,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2009,6,19]],"date-time":"2009-06-19T00:00:00Z","timestamp":1245369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>An inverse association between serum total cholesterol and cancer mortality cast a controversy for cause or result of low cholesterol on cancer risk. Therefore, we examined a total of 33,368 Japanese men and women aged 40\u201369 years, who were free of prior diagnosis of cancer and cardiovascular disease, undertook serum total cholesterol measurement and completed a food frequency questionnaire between 1990 and 1994. They were followed to ascertain incident total and major sites of cancer until the end of 2004 to examine sex\u2010specific associations between cholesterol and cancer risk by incident time, stage and virus infection. After 412,714 person\u2010years of follow\u2010up, 2,728 incident cancers were documented. Serum total cholesterol levels were inversely associated with risk of total cancer in men, with strong inverse associations with stomach cancer in men and liver cancer in both sexes. After exclusion for first 3\u2010year incident cases and advanced cases with metastasis, the inverse association diminished for total and stomach cancers but remained for liver cancer. The multivariable hazard ratios (95% CI) for serum total cholesterol &lt;4.14 mmol\/l <jats:italic>versus<\/jats:italic> 4.65\u20135.16 mmol\/l were 1.15(0.92\u20131.43); <jats:italic>p<\/jats:italic>\u2010trend across the overall cholesterol categories = 0.25 for total cancer and 1.18(0.79\u20131.75), <jats:italic>p<\/jats:italic>\u2010trend = 0.04 for stomach cancer and 5.12(1.65\u201315.9), <jats:italic>p<\/jats:italic>\u2010trend = 0.0011 for liver cancer in men, and 5.73(1.57\u201320.9), <jats:italic>p<\/jats:italic>\u2010trend = 0.0007 for liver cancer in women. The sustained excess risk of liver cancer associated with low cholesterol was observed regardless of hepatitis\u2010C\u2010virus infection and drinking habits. Although the inverse association for liver cancer remained to be examined further, our findings do not support that low serum total cholesterol levels increase risks of total cancer and other major sites. \u00a9 2009 UICC<\/jats:p>","DOI":"10.1002\/ijc.24668","type":"journal-article","created":{"date-parts":[[2009,6,19]],"date-time":"2009-06-19T18:05:12Z","timestamp":1245434712000},"page":"2679-2686","source":"Crossref","is-referenced-by-count":118,"title":["Serum cholesterol levels in relation to the incidence of cancer: The JPHC study cohorts"],"prefix":"10.1002","volume":"125","author":[{"given":"Hiroyasu","family":"Iso","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manami","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoichiro","family":"Tsugane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,8,8]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00052142"},{"key":"e_1_2_6_3_2","first-page":"1179","article-title":"Serum cholesterol and colon cancer incidence in Hawaiian Japanese men","volume":"67","author":"Stemmermann GN","year":"1981","journal-title":"J Natl Cancer Inst"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1981.03310280023021"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)90890-7"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.298.6678.920"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(84)90107-3"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(86)90034-2"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198612253152601"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(88)90056-X"},{"key":"e_1_2_6_11_2","doi-asserted-by":"crossref","first-page":"162","DOI":"10.3109\/00365529709000187","article-title":"Blood lipid and lipoprotein levels and the risk of cancer of the colon and rectum","volume":"32","author":"Garrd M","year":"1997","journal-title":"Scand J Gastroenterol"},{"key":"e_1_2_6_12_2","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1001\/jama.1990.03440150091032","article-title":"Declining serum cholesterol levels prior to diagnosis of colon cancer: a time trend, case\u2010control study","volume":"263","author":"Winawer SJ","year":"1990","journal-title":"JAMA"},{"key":"e_1_2_6_13_2","first-page":"3198","article-title":"Changes in plasma lipid and lipoprotein cholesterol and weight prior to the diagnosis of cancer","volume":"51","author":"Kritchevsky SB","year":"1991","journal-title":"Cancer Res"},{"key":"e_1_2_6_14_2","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1073\/pnas.75.11.5683","article-title":"Cholesterol: a critical cellular component for T\u2010lymphocyte cytotoxicity","volume":"75","author":"Heiniger HJ","year":"1978","journal-title":"Proc Natl Acad Sci USA"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cellsig.2006.05.012"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-008-0171-3"},{"key":"e_1_2_6_17_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/BJN20061937","article-title":"Egg consumption, serum total cholesterol concentrations and coronary heart disease incidence: Japan public health center\u2010based prospective study","volume":"96","author":"Nakamura Y","year":"2006","journal-title":"Br J Nutr"},{"key":"e_1_2_6_18_2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2188\/jea.2.75","article-title":"Cross\u2010sectional epidemiologic study for assessing cancer risks at the population level. 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