Heart drug reduces colon cancer risk

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listener - 26 May 2005 00:14 GMT

BOSTON (Reuters) - People taking statin drugs to stem the progression of
heart disease may be getting an extra benefit: protection from colorectal
cancer, according to research released on Wednesday.

The findings, published the New England Journal of Medicine, showed that
taking cholesterol-lowering medicine cuts the risk of colon cancer by 47
percent.

But in an editorial in the Journal, Ernest Hawk and Jaye Viner of the
National Cancer Institute said that without further research, "it is too
early to recommend statins as chemopreventive agents against colorectal
cancer" outside of a research setting.

The time window to do that research is closing, they warned. As statins are
prescribed for more and more people with high cholesterol levels, the
ability to do tests where volunteers get a placebo instead of the drug "may
soon disappear."

The latest results updated findings released in June of last year showing a
51 percent reduction in the colorectal cancer risk among people in northern
Israel who had been taking statins, the most widely prescribed class of
medicines in the United States, with annual sales of $12.5 billion.

While the June report assessed 3,342 patients, the new findings include
data from 626 additional people.

The research team, led by Jenny Poyntner of the University of Michigan in
Ann Arbor, estimated that 4,814 people would have to take statins regularly
to prevent one case of colorectal cancer.

"In a high-risk population, such as those with a family history of
colorectal cancer, approximately half as many would need to be treated in
order to prevent one case," they said.

According to several other studies released in the past two months, statins
also appear to cut the risk of prostate, pancreatic and throat cancers.

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Jim Chinnis - 26 May 2005 00:48 GMT

listener <listener@nospam.net> wrote in part:

>BOSTON (Reuters) - People taking statin drugs to stem the progression of
>heart disease may be getting an extra benefit: protection from colorectal
[quoted text clipped - 32 lines]
>According to several other studies released in the past two months, statins
>also appear to cut the risk of prostate, pancreatic and throat cancers.

The observational studies seem to line up to support around a 50%
decrease in most cancers. The randomized trials pretty much show
no effect.

While randomized trials trump observational studies, the
randomized trials cover a comparatively shorter period of statin
exposure. That may explain the difference, assuming, of course,
that the various studies aren't overly cherry-picked...
--
Jim Chinnis Warrenton, Virginia, USA

Reply to this Message

Jim Chinnis - 27 May 2005 00:27 GMT

Jim Chinnis <jchinnis@SPAMalum.mit.edu> wrote in part:

>The observational studies seem to line up to support around a 50%
>decrease in most cancers. The randomized trials pretty much show
[quoted text clipped - 4 lines]
>exposure. That may explain the difference, assuming, of course,
>that the various studies aren't overly cherry-picked...

Talkin' to myself here:

I haven't seen the full text of the observational studies yet. I
suspect that they may not have controlled for cholesterol level.
It is conceivable that people who took statins had higher
cholesterol than those who didn't and that *might* explain the
lower cancer rates. (Though I don't think the relationship of
cholesterol level to cancer incidence is well-established,
either!)

The problem with observational studies is that one can always
second-guess them.
--
Jim Chinnis Warrenton, Virginia, USA

Reply to this Message

Bill - 27 May 2005 04:59 GMT

> Jim Chinnis <jchinnis@SPAMalum.mit.edu> wrote in part:
>
[quoted text clipped - 21 lines]
> --
> Jim Chinnis Warrenton, Virginia, USA

I was actually thinking about that a little bit. There may be some problems
with controlled studies also. One thing about colon cancer is that it takes a
long time to develop - that's why they recommend colonoscopies every 5 years
or so unless you are at some type of risk. So the trial should last a long
time. What do you do about people who want to start taking statins over that
period. You can't blindly go on and let people get a double dose can you? But
if you wash people out who develop high lipids you are biasing the results.
But if the patient becomes aware, it is not double blind.

Also, do you have and obligation to tell the physician and patient which arm
of the study they are in at the beginning because of the known side effects of
statins. And do you have any ethical obligation to tell the patient what the
study is about, the risks of colon cancer, the need for tests, and that they,
presumably, will need to agree to a colonoscopy at the end of the trial - or
else the trial will have to be longer and/or involve more people.

However, if the patient becomes aware they are more likely to have a test
which will reduce the colon cancer rate for the group.

Bill

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