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Serum lipid profiles and risk of colorectal cancer: a prospective cohort study in the UK Biobank



It remains unclear whether serum lipids influence colorectal cancer (CRC) risk.


We conducted a prospective cohort study of 380,087 adults aged 40–69 years in the UK Biobank. Serum high-density cholesterol, low-density cholesterol, total cholesterol, triglycerides, and apolipoprotein A and B were measured. We used Cox proportional hazard models to estimate the multivariable hazard ratios (HRs) of CRC according to one standard deviation (SD) increment in serum lipids. We conducted subgroup analysis by tumour anatomical subsites.


During a median of 10.3 years of follow-up, we documented 2667 incident CRC cases. None of the lipid biomarkers was associated with the risk of CRC after adjusting for potential confounding factors, including body mass index and waist circumference. When assessed by cancer subsites, serum triglycerides was associated with an increased risk of cancer in the caecum and transverse colon, with the HR of 1.12 (95% CI, 1.00–1.25) and 1.29 (95% CI, 1.09–1.53), respectively; and apolipoprotein A was associated with a lower risk of hepatic flexure cancer (HR, 0.73, 95% CI, 0.56–0.96).


Serum lipid profiles were not associated with colorectal cancer risk after adjusting for obesity indicators. The potential subsite-specific effects of triglycerides and apolipoprotein A require further confirmation.

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Fig. 1: The flow diagram for exclusion and inclusion.


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We thank the UK Biobank participants and individuals who built the open access resource.

Author information




Z.F. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study conception and design: Z.F. and M.S. Acquisition of data: M.H. and M.S. Statistical analysis: Z.F. and M.H. Interpretation of results: all authors. Drafting of the paper: Z.F. Critical revision of the paper for important intellectual content: M.S. and Z.F.

Corresponding author

Correspondence to Mingyang Song.

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Ethics approval and consent to participate

All participants have provided their informed consent to participate. Studies based on UK Biobank were performed in accordance with the Declaration of Helsinki. Ethical approval and consent were granted by the North West-Haydock NRES multicentre ethics committee, REF: 16NW/0274.

Data availability

Approval for the study and permission to access the data was granted by the UK Biobank Resource under Application Number 46466 that is open access. Bona fide researchers can access the UK Biobank dataset by registering and applying at

Competing interests

The authors declare no competing interests.

Funding information

This work was supported by the American Cancer Society (MRSG-17-220-01-NEC to M.S.) and the U.S. National Institutes of Health (R00 CA215314 to M.S.). The UK Biobank was primarily funded by the Wellcome Trust and the Medical Research Council. Other areas of funding include the United Kingdom Department of Health, the Scottish Government, the Welsh Assembly Government, the British Heart Foundation, and Diabetes UK.

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Fang, Z., He, M. & Song, M. Serum lipid profiles and risk of colorectal cancer: a prospective cohort study in the UK Biobank. Br J Cancer 124, 663–670 (2021).

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