VOL. 7, No. 1/2, December 2011

E. De Stefani, et al. [2011] Med. Hypotheses Res. 7: 17−25.

Dietary Cholesterol and Risk of Cancer: A Multi-site
Case-Control Study in Uruguay

Eduardo De Stefani*, Hugo Deneo-Pellegrini, Alvaro L. Ronco,
Paolo Boffetta, Pelayo Correa, María Mendilaharsu and Gisele Acosta

Epidemiology Group, Department of Pathology, School of Medicine, Uruguay [D.D.S., M.
M., G.A.]; Department of Epidemiology, School of Medicine, Maldonado, Uruguay [A.L.R.];
The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, U.S.A. [P.B.];
and Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical
Center, Nashville, TN, U.S.A. [P.C.]

Abstract. The scientific evidence has inconsistencies regarding the relationship between
dietary cholesterol and risk of cancer. The present study aimed to assess the odds ratios
(ORs) of eleven cancer sites in relation to intake of dietary cholesterol. In the time period
1996-2004, 3,539 patients with several cancer sites (oral cavity and pharynx, esophagus,
stomach, colon, rectum, larynx, lung, female breast, prostate, urinary bladder, kidney) and
2,032 hospitalized controls were interviewed using a structured questionnaire by two trained
social workers. Dietary cholesterol was estimated through a local table of chemical
composition of foods. ORs for these cancer sites were calculated through polytomous
(multinomial) multiple regression. Dietary cholesterol was positively associated with the risk
of colon, lung, breast, prostate, and urinary bladder cancer and inversely associated with
gastric cancer, with the highest OR being observed for bladder cancer (OR 2.57, 95% CI 1.57-
4.21). Cancers of the oral cavity, pharynx, larynx, esophagus, rectum and kidney were not
significantly associated with risk. The present study adds to the evidence that dietary
cholesterol could be a risk factor for several cancer sites, suggesting that lowering the intake
of red meat, processed meat, and eggs could be a useful step in the prevention of certain

* Correspondence: Dr. Eduardo De Stefani, Avenida Brasil 3080 Department 402, 11300
Montevideo, Uruguay. TEL: +598 2 708 23 14. E-MAIL: