[email hidden] (Zee) wrote in message news:<[email hidden]>...
Quoted message said:LANCET: conflicting ideas on statins and cancer Jun
11, 2004
Conflicting ideas on statins and cancer
www.theheart.org (behind subscription)
New Orleans, LA and Lausanne, Switzerland - There have
been conflicting reports this week on the role of statins
and the development of cancer.
COMMENT:
Yes, conflicting ideas. One set of ideas based on actual
data from human trials, and the other based solely on
somebody's blue-sky unproven pet mechanistic hypothesis,
which has no backing even from animal studies, and in humans
is not only not consistent with the data, but actually
conflicts with it. So you see that the opinions of
scientists are not exactly of the same quality.
Quoted message said:A case control study presented during the American Society
of Clinical Oncology (ASCO) meeting held earlier this week
in New Orleans suggested that statins may prevent
colorectal cancer, but a letter in the June 12, 2004 issue
of the Lancet raises the idea that statins could actually
trigger some types of cancer as well as autoimmune
disease.
A 51% reduction in the risk of colorectal cancer The case
control study, presented at ASCO by Dr Stephen Gruber
(University of Michigan, Ann Arbor), involved 1849 Israeli
colorectal cancer patients (cases) and 1959 healthy
controls matched for age, gender, and ethnic origins. The
use of statins for at least five years was associated with
a 51% reduction in the risk of colorectal cancer, with
statins being used by 11.3% of controls and 5.8% of cases.
Gruber commented: "These observational data suggest that
statins deserve further investigation in chemoprevention
and therapeutic clinical trials." He added that the use of
nonstatin cholesterol-lowering agents was not associated
with reduced risk of colorectal cancer, suggesting that
the protective effect was due to the statins rather than
to the reduction in cholesterol. Gruber also noted that
statins inhibit RAS and RhoA, two proteins that are
potentially carcinogenic.
COMMENT:
I'm surprised non-statin anti-cholesterol drugs didn't
actually INCREASE GI cancers, since that is what has
happened in animal studies, and in more than one human
trial. The fibrate class of drugs in particular should be
removed from the market.
Quoted message said:***************************
Inhibition of selenoprotein However, in a letter in this
week's Lancet, Dr Bernard Noël (Centre Hospitalier
Universitaire Vaudois, Lausanne, Switzerland) puts across
a very different view.[1]
He notes that a previous article in the Lancet has
suggested that myopathy and some other side effects of
statins might be attributable to inhibition of
selenoprotein synthesis.
He further points out that selenoprotein inhibition might
heighten the risk of prostate and colon cancer and also
trigger autoimmune diseases, more than 20 cases of which
have been reported in patients treated with statins.
And unbelievably he gets away with this argument in the
Lancet (albeit in a letter). No doubt 20 cases of prostate
cancer have been seen in the thousands upon thousands of
people taking statins. Nobody claimed statins completely
prevent prostate cancer. But in order to see what impact
they have, you need to compare with prostate incidence in a
control group NOT taking statins. I've been able to find two
studies which do this, and one finds on statistical increase
in prostate cancer risk in statin users, and the other
actually finds a statistically significant DECREASE in risk.
So whatever Dr. Noël's pet theories about whether or not
statins "might" heighten these risks based on some metabolic
pathway he's identified, he should realize that there's no
evidence for it in the real world, and should therefore have
kept his mouth shut.
Quoted message said:"Further studies are, therefore, warranted to determine the
long-term safety of these lipid-lowering agents," he [Noël]
concludes.
COMMENT:
Of course. And they are being done. But to make a statement
like this, which suggests that none have been done yet, is
completely irresponsible. What a maroon!
1: Br J Cancer. 2004 Feb 9;90(3):635-7.
Statin use and cancer risk in the General Practice
Research Database.
Kaye JA, Jick H.
Boston Collaborative Drug Surveillance Program, Boston
University School of Medicine, 11 Muzzey Street, Lexington,
MA 02421, USA. [email hidden]
In a matched case-control study using the General Practice
Research Database, current statin use was not associated
with a significantly altered risk of any of 13 studied
cancers. Untreated hyperlipidaemia was associated with
slightly increased risks of colon cancer (relative risk 1.8;
95% confidence interval
2.2-2.8), prostate cancer (1.5; 1.1-2.0), and bladder
cancer (1.9;
3.2-3.1).
PMID: 14760377 [PubMed - indexed for MEDLINE]
4: Epidemiology. 2002 May;13(3):262-7.
Statin use and the risk of breast and prostate cancer.
Coogan PF, Rosenberg L, Palmer JR, Strom BL, Zauber AG,
Shapiro S.
Slone Epidemiology Unit, Boston University School of
Medicine, Brookline, MA 02446, USA. [email hidden]
BACKGROUND: Laboratory data suggest that the cholesterol-
lowering "statin" drugs may have chemopreventive potential
against cancer at various sites, including breast and
prostate. However, in one trial of pravastatin there was a
significant excess of breast cancer in the treatment group.
In the present study, we assessed the relation of statin use
to the risk of breast and prostate cancer in our hospital-
based Case-Control Surveillance Study of Drugs and Serious
Illnesses. METHODS: Cases were 1,132 women with breast
cancer and 1,009 men with prostate cancer; controls were
1,331 women and 1,387 men admitted for conditions unrelated
to statin use. We used multivariate unconditional logistic
regression models to estimate odds ratios (ORs) and 95%
confidence intervals
(CIs) for use of statins compared with no use. RESULTS: The
OR for breast cancer among statin users was 1.5 (95%
CI = 1.0-2.3), largely accounted for by an OR of
1.8 (95% CI = 0.9-3.6) among cases with carcinoma in situ.
Among invasive cases, the OR was 1.2 (95% CI = 0.7-2.0).
The odds ratio for prostate cancer overall was 1.2 (95% CI
= 0.8-1.7), and it was 1.4 (95% CI = 0.7-2.5) for Stage A.
CONCLUSIONS: The data from the present study do not
support a protective effect of statins against breast or
prostate cancer. Detection bias is a possible explanation
for the higher ORs observed for carcinoma in situ or early-
stage cancer as compared with more invasive cancer.
PMID: 11964926 [PubMed - indexed for MEDLINE]
