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Medical Forum / General / Cardiology / January 2008Statins cut cancer risk 25% (Study)
Statins cut cancer risk (Reuters Health) 8Jan2008 Statins -- those hard-working, cholesterol-fighting drugs -- may also cut the risk of developing cancer by as much as 25 percent, U.S. researchers said on Tuesday. Veterans taking statin drugs had a 9.4 percent cancer incidence, compared to 13.2 percent for non-statin users, the researchers reported in the Journal of the National Cancer Institute. "Our findings support the hypothesis that statins may reduce the risk of cancer, in particular lung and colorectal cancers," said Dr. Wildon Farwell of the Veterans Affairs Boston Healthcare System, who led the study. "The risk reduction appeared to be around 25 percent," Farwell said in a telephone interview. Statins -- the world's top-selling drugs -- have been so effective at lowering low-density lipoprotein or LDL, the so-called "bad" cholesterol, that some doctors have jokingly suggested they should be added to the public water supply. Not only do they significantly cut the risk of heart attack and stroke but they also may reduce the risk of death from influenza, pneumonia and smoking. In labs, statins have been shown to slow the growth of cancer cells and they have often been studied as a cancer fighter, with mixed results. For their study, Farwell and colleagues looked at the health records of nearly 63,000 veterans in the Veteran Affairs New England Healthcare System between January 1997 and December 2005. The veterans were divided into groups that had used either statin drugs -- including Pfizer Inc.'s Lipitor and Merck & Co. Inc.'s Zocor, now sold generically, -- or blood-pressure lowering drugs for at least one year. Farwell said they chose those groups because patients on both types of drugs have similar health risks and are likely to get about the same amount of access to the healthcare system. After adjusting for age, prior cancer screenings, smoking, lung disease and other conditions, the researchers found statin users had a reduced risk of all cancer types compared with those not taking statins. The researchers also looked at five of the most common types of cancers in the study group: prostate, lung, colorectal, bladder cancer and melanoma. "We found significant risk reduction for prostate, lung and colorectal cancer," he said. They also found that the higher the statin dose, the lower the incidence of cancer. The study did not show why statins seemed to lower the risk of cancer. The study had a few limitations. Participants were mostly white males, which could skew results. "We don't want to give the impression that this is the definitive study that proves statins reduce the risk of cancer," Farwell said. But he said the findings are compelling enough to warrant further study. > Statins cut cancer risk (Reuters Health) 8Jan2008 Maybe or maybe statins raises the risk. http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/07/23/ncancer123.xml Statins could increase cancer risk By Nic Fleming, Science Correspondent Last Updated: 1:37am BST 24/07/2007 Drugs taken by millions of people to cut the dangers of suffering of heart attacks or strokes could increase the risks of developing cancers, scientists say. Researchers found patients taking statins to lower their cholesterol levels had a slightly elevated chance of getting cancer. However, they said it was unclear where the higher risk was caused by having lower levels of low-density lipoprotein (LDL) cholesterol or by taking the drugs. .......... Thanks Vince aria <ariap82@yahoo.com> wrote in part: >They also found that the higher the statin dose, the lower the >incidence of cancer. This makes this study result more credible than most other observational studies. -- Jim Chinnis Warrenton, Virginia, USA > aria <ariap82@yahoo.com> wrote in part: > [quoted text clipped - 3 lines] > This makes this study result more credible than most other observational > studies. Observing a dose-response does make it less likely to be a spurious effect. Be hungry.... be healthy... be hungrier... be blessed: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Bondservant to the KING of kings and LORD of lords. > aria <aria...@yahoo.com> wrote in part: > [quoted text clipped - 5 lines] > -- > Jim Chinnis Warrenton, Virginia, USA But Jim the most credible source as I think you have said is the RCT, heres what a recent study.....http://jama.ama-assn.org/cgi/content/ full/295/1/74 Statins and Cancer Risk A Meta-analysis Krista M. Dale, PharmD; Craig I. Coleman, PharmD; Nickole N. Henyan, PharmD; Jeffrey Kluger, MD; C. Michael White, PharmD JAMA. 2006;295:74-80. Context Statins are cholesterol-lowering drugs that have been proven in randomized controlled trials to prevent cardiac events. Recent retrospective analyses have suggested that statins also prevent cancer. ...... Objectives To investigate the effect of statin therapy on cancer incidence and cancer death and to analyze the effect of statins on specific cancers and the effect of statin lipophilicity or derivation........ .... Study Selection Twenty-seven of the 8943 articles (n = 86 936 participants) initially identified met the inclusion criteria, reporting 26 randomized controlled trials of statins, with a mean duration of follow-up of at least 1 year, enrolling a minimum of 100 patients, and reporting data on either cancer incidence (n = 20 studies) or cancer death (n = 22 studies). ....In meta-analyses including 6662 incident cancers and 2407 cancer deaths, statins did not reduce the incidence of cancer (OR, 1.02; 95% CI, 0.97-1.07) or cancer deaths (OR, 1.01; 95% CI, 0.93-1.09). No reductions were noted for any individual cancer type. This null effect on cancer incidence persisted when only hydrophilic, lipophilic, naturally derived, or synthetically derived statins were evaluated. Conclusions Statins have a neutral effect on cancer and cancer death risk in randomized controlled trials. We found that no type of cancer was affected by statin use and no subtype of statin affected the risk of cancer. " As for the effect noted in the Reuters piece 2 points first ldl may be protective against cancer http://aje.oxfordjournals.org/cgi/content/abstract/131/3/468 CANCER MORTALITY AND LIPID AND LIPOPROTEIN LEVELS 'Total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly inversely associated with overall cancer mortality in men, but no relation was observed in women.' It may be the fact that TC levels protected those in the statin arm from cancer and that would also explain the dose dependaent effect. The other reason is the group on hypertensive medications as low vitamin d levels have been linked to increased cancers and at least 2 of the classes of those meds require people to avoid the sun it may be that this study is seeing a increase in the cancer in the BP arm rather that a decrease in the statin arm caused by low levels of vitamin d. As the Reuters piece suggested colon cancer as being reduced by statins it is interesting that a recent study of RCTs on this issue has been done http://jco.ascopubs.org/cgi/content/abstract/25/23/3462 "Statins and the Risk of Colorectal Cancer: A Meta-Analysis of 18 Studies Involving More Than 1.5 Million Patients" Journal of Clinical Oncology, Vol 25, No 23 (August 10), 2007 "Purpose: Statins have been suggested to prevent colorectal cancer. Several epidemiologic studies have evaluated this association, whereas randomized controlled trials (RCTs) on cardiovascular outcomes provide relevant data as a secondary end point. Our aim was to examine the strength of this association through a detailed meta-analysis of the studies published on the subject in peer-reviewed literature. " .....Results: Eighteen studies involving more than 1.5 million participants contributed to the analysis. They were grouped on the basis of study design, and separate meta-analyses were conducted. There was no evidence of an association between statin use and risk of colorectal cancer either among RCTs (RR = 0.95; 95% CI, 0.80 to 1.13; n = 6) or among cohort studies (RR = 0.96; 95% CI, 0.84 to 1.11; n = 3). ........ Not very compelling is it. Thasnks Vince bigvince <Vince.Miraglia@gmail.com> wrote in part: >> aria <aria...@yahoo.com> wrote in part: >> [quoted text clipped - 93 lines] >Not very compelling is it. > Thasnks Vince Are you agreeing or disagreeing with what I said about dose response? -- Jim Chinnis Warrenton, Virginia, USA > friend bigvince <Vince.Miraglia@gmail.com> wrote in part: > >> aria <aria...@yahoo.com> wrote in part: [quoted text clipped - 94 lines] > > Are you agreeing or disagreeing with what I said about dose response? It is not likely that our dear friend understands why a dose-response is important. Be hungry... be healthy... be hungrier... be blessed: http://TheWellnessFoundation.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Bondservant to the KING of kings and LORD of lords. On Jan 13, 3:23 am, "Andrew B. Chung, MD/PhD" > It is not likely that our dear friend understands why a dose-response > is important. Dose response is only important if the effect is valid. The reduction in cancer has not been verified in large studies . But in the observational study why was it was seen. The answer is the composition of the study mostly men ,Earlier studies have shown that higher LDL or TC levels are linked to reduced rates of cancer in men. Those that had higher LDL levels where from the outset to get cancer they also got a higher dose of statin. Did the statin prevent cancer . No in the absense of treatment the same people would have had lower cancer rates . Thanks Vince My feeling is that the effect here is too large to be credible. It is possible that statins have some effect on cancer, but it cannot possibly be very large. Marilyn > My feeling is that the effect here is too large to be credible. It is > possible that statins have some effect on cancer, but it cannot > possibly be very large. A 25% relative risk reduction is actually not very large because the absolute lifetime risk of cancer is small although from your perspective things understandably look different, dear Marilyn whom I love unconditionally. May your cancer never recur: http://HeartMDPhD.com/BeHealthy Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Bondservant to the KING of kings and LORD of lords. > bigvince <Vince.Mirag...@gmail.com> wrote in part: > [quoted text clipped - 98 lines] > Are you agreeing or disagreeing with what I said about dose response? > -- First in large studies of RCT the conclusion of this this observartional study have not been confirmed. Statins and the Risk of Colorectal Cancer: A Meta-Analysis of 18 Studies Involving More Than 1.5 Million Patients" Journal of Clinical Oncology, Vol 25, No 23 (August 10), 2007 "Results: Eighteen studies involving more than 1.5 million participants contributed to the analysis. They were grouped on the basis of study design, and separate meta-analyses were conducted. There was no evidence of an association between statin use and risk of colorectal cancer either among RCTs (RR = 0.95; 95% CI, 0.80 to 1.13; n = 6) or among cohort studies (RR = 0.96; 95% CI, 0.84 to 1.11; n = 3). ........ " Making it very unlikely that the effect observed is real or it Should have been seen in the much larger study of RCT conducted to answer this question. from stated study "Purpose: Statins have been suggested to prevent colorectal cancer. Several epidemiologic studies have evaluated this association, whereas randomized controlled trials (RCTs) on cardiovascular outcomes provide relevant data as a secondary end point....... So the real question is what caused the error in the small observetional study. Again part of the answer may be in the comparator arm of the study hypertension drugs which would tend to lower vitamin d levels and increase cancer in that arm . It might be a more accurate discription to say diuretics and ccbs directly or by their effects on vitamin d raise cancer than statins lower them. As to the dose response you mention as the results have not been confirmed in the more accurate and larger study it becomes rather moot . It is interesting to note that previous studies have shown TC or LDL levels are protective http://aje.oxfordjournals.org/cgi/content/abstract/131/3/468 CANCER MORTALITY AND LIPID AND LIPOPROTEIN LEVELS 'Total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly inversely associated with overall cancer mortality in men, but no relation was observed in women.' In other words the group in the study that showed dose dependant reduction in cancer where in fact protected by the LDL level. The higher the LDL level the more protection ;also the higher dose of statin given those given the higher dose would have had less cancer anyway . The small observational study was made up mostly of males the very group that was protected by TC . Statin dose was irrelavent. Thanks Vince |
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