Serum uric acid and risk of cancer mortality in a large prospective male cohort

Objective To examine the prognostic role of serum uric acid (SUA) for cancer mortality in apparently healthy men across a wide age range. Methods Prospective data from a large cohort of 83,683 male Austrian adults with a median follow-up of 13.6 years was analyzed. Cox proportional hazards models, adjusted for established risk factors, were calculated to evaluate SUA as a predictive marker for fatal cancer events. Results High SUA (> 6.71 mg/dl) was independently associated with increased risk of mortality from all cancers, showing a clear dose-response relationship (p for trend < 0.0001); the adjusted hazard ratio for the highest versus lowest quintile of SUA was 1.41 (1.22-1.62). In subgroup analyses this hazard ratio increased to 1.53 (1.29-1.80) for participants aged < 65 years. When considering the time interval between baseline SUA measurement and subsequent death, SUA levels were more predictive for "late deaths", occurring 10 or more years after screening (HR 1.65 [1.35-2.03], p < 0.0001), in comparison to deaths within 10 years after SUA measurement. In cancer site-specific analyses, SUA was significantly associated with deaths from malignant neoplasms of digestive organs (p = 0.03) and respiratory system and intrathoracic organs (p < 0.0001). Elevated SUA was further independently related to an increased risk of all-cause mortality (p < 0.0001). Conclusions Our results are contrary to the proposed antioxidant, inhibitory effect of SUA against cancer and rather suggest high SUA to be a valuable long-term surrogate parameter, indicative for a life-style at increased risk for the development of cancer.