To the Editor.—
It is difficult to explain the intriguing negative correlation between serum cholesterol level and colon cancer as noted by Williams and co-workers (1981;245:247). One possibility might be that for some persons, low serum cholesterol level is associated with excess cholesterol excretion that could act as a promoter for colon cancer, as suggested by Cruse et al.1 The World Health Organization clofibrate study tends to support this hypothesis, since pharmacologic lowering of serum cholesterol level increased the risk of bowel cancer.2 The presumption is that cholesterol excretion was also increased, since there was a definite increase in gallstone-related disease. It would be most interesting to find out if there is any relation between gallstones, serum cholesterol level, and colon cancer in the Framingham group of patients.
Lowenfels AB. Serum Cholesterol and Colon Cancer. JAMA. 1981;246(3):213. doi:10.1001/jama.1981.03320030011007