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    Old 06-07-2004, 10:26 PM   #1
    rahod
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    Statins and colorectal cancer

    June 7, 2004 (New Orleans) -- Colon and rectal cancers are the No. 2 cancer killers in the United States; now new research suggests a type of drugs that lowers cholesterol may cut the risk of developing these cancers.

    Statins, marketed under names such as Crestor, Lescol, Lipitor, Mevacor, Pravachol, and Zocor, are a type of drug commonly prescribed to lower cholesterol, but cancer researchers suspect they may also inhibit the growth of cancer.

    To test that theory, S.B. Gruber, MD, PhD, and colleagues from the University of Michigan along with scientists at CHS National Cancer Control Center in Haifa, Israel, looked at the use of statin drugs in 1,849 people with colorectal cancer and in 1,959 people without the disease. The study results were presented at the 40th Annual Meeting of the American Society of Clinical Oncology.

    51% Colon Cancer Risk Reduction

    Among the colon cancer patients, 6% had taken statins, while 11% of the healthy people had used the drugs, Gruber tells *****. That means that taking statin drugs was associated with a 51% reduction in risk of colon cancer.

    However, many factors can alter the risk for colon cancer so Gruber and his colleagues factored in things like aspirin use, diet -- especially a diet high in fruits and vegetables, exercise, and family history.

    When they added in those factors, "use of statins was still associated with a 46% reduction in risk."

    Moreover, Gruber says the benefit is not just about lowering cholesterol because when he looked at other drugs used to lower cholesterol levels, "we found no benefit."

    In Israel the most commonly used statins are Zocor and Pravachol and the benefit was the same with both drugs, which makes Gruber think that all statins are likely to offer the same benefit.

    Statins for Prevention Not Yet Recommended

    But he says it is too early to suggest taking statins as a means of preventing colorectal cancer.

     
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    Old 06-08-2004, 03:25 AM   #2
    SafetyJ2006
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    Re: Statins and colorectal cancer

    Have you noticed some studies say statins may cause cancer, this study says it may prevent it. This is such a controvertial area of research, I would be very careful jumping to any conclusions, especially when there are so many studies and counter studies.

    However, I was on a drug called pramipexole for my Parkinson's Disease. I started it in April 1998. I also became a compulsive gambler in 1998. In 2003, a study came out that pramipexole increased compulsivity and PD patients who were on it had five times more chance of being a compulsive gambler than those who were not. I stopped the drug, my compulsivity stopped.

    The only difference here is this: the statins are not proven to prevent CAD and heart disease, two conditions most of those who take it have. It is proven to decrease cholesterol and lipids. Pramipexole did positively affect my PD symptoms.

    Also, at the risk of sounding conspiritorial, I must ask, who funded these studies?

    Here is some information from Bandolier, a medical journal in the UK:

    A number of epidemiological studies have reported an association between low cholesterol levels and increased incidence of cancer of the gastrointestinal tract. Most of the studies predate the introduction of statins in 1987, and when the lipid-lowering potential of these drugs was realised there were fears that they could increase the incidence of gastrointestinal cancers. However, causality remains controversial, and the association could be explained by confounding factors.

    Under experimental conditions, statins have been shown to increase the frequency of several cancers in rodents, at levels of exposure similar to that used therapeutically in humans [1]. Recent in vitro studies demonstrate that statins can act as immunoregulators, and it is suggested that they could contribute to the development of malignant diseases by this mechanism [2, 3].

    At the same time, other studies have suggested that statins have an inhibitory effect on cancer cell proliferation in vitro [4, 5], in an animal model [5] and in humans, when used for adjuvant treatment [6]. They may act as triggers of tumor-specific apoptosis [7].

    Two recent case control studies, involving over 10,000 individuals, have looked for changes in the rates of cancer at specific sites, but failed to demonstrate a clear association with statin use [8, 9].
    Review evidence

    The strongest evidence, in terms of methodological rigor, number of patients and duration of follow-up, comes from large, randomised, double-blind, placebo-controlled trials. A meta-analysis of five trials studied 30,817 patients treated for 5 years, and found no association between the use of statins and either fatal or non-fatal cancers [10].

    Bandolier has added to the meta-analysis the results of another very large trial published subsequently [11]. Not one trial reported all of the outcomes, and most reported cancer in different ways.

    Looking at all cancers together might obscure a change in the rate of a specific type or site of cancer. Reporting of site-specific cancers in the trials was incomplete, but the available data showed little evidence that statins influence cancer rates at specific sites.
    Comment

    So far the data from large randomized trials is mostly reassuring, although incomplete. The average duration of the trials was 5 years, but most patients taking stains would expect to do so for life. Cancers can occur after long latency periods following exposure to the carcinogen, and we do not yet have the length of follow-up necessary to exclude a carcinogenic effect of statins. The answer will come from epidemiological surveillance and studies with long-term follow-up.

    References

    1. TB Newman, SB Hulley. Carcinogenicity of lipid-lowering drugs. JAMA 1996 275: 55-60.
    2. B Kwak et al. Statins as a newly recognized type of immunomodulator. Nat Med 2000 6: 1399-402.
    3. G Weitz-Schmidt et al. Statins selectively inhibit leukocyte function antigen-1 by binding to a novel regulatory integrin site. Nat Med 2001 7: 687-92.
    4. T Kusama et al. Inhibition of epidermal growth factor-induced RhoA translocation and invasion of human pancreatic cancer cells by 3-hydroxyl-3-methylglutaryl-coenzyme A reductase inhibitors. Cancer Res 2001 61: 4885-91.
    5. T Kusama et al. 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors reduce human pancreatic cancer cell invasion and metastasis.
    6. S Kawata et al. Effect of pravastatin on survival in patients with advanced hepatocellular carcinoma. A randomized controlled trial. Br J Cancer 2001 84: 886-91.
    7. WW Wong et al. HMG-CoA reductase inhibitors and the malignant cell: the statin family of drugs as triggers of tumor-specific apoptosis. Leukemia 2002 16: 508-19.
    8. L Blais et al. 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and the risk of cancer: a nested case-control study. Arch Intern Med 2000 160: 2363-8.
    9. PF Coogan et al. Statin use and the risk of breast and prostate cancer. Epidemiology 2002 13: 262-7.
    10. LM Bjerre, J LeLorier. Do statins cause cancer? A meta-analysis of large randomized clinical trials. Am J Med 2001 110: 716-23.
    11. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2002 360:7-22.

    Jeff

    Last edited by SafetyJ2006; 06-08-2004 at 03:35 AM.

     
    Old 06-08-2004, 05:49 AM   #3
    zip2play
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    Re: Statins and colorectal cancer

    rahod,

    I'd love to see the mechanics of this study and, of course, would be extremely pleased to accrue any additional benefits from my daily statin use besides the well proven benefits of an excellent lipid profile and the well proven large reduction from the risk of coronary morbidity and mortality!

    I DO hope that the evidence goes deeper than just examining the two groups and concluding
    Quote:
    "Among the colon cancer patients, 6% had taken statins, while 11% of the healthy people had used the drugs, Gruber tells *****. That means that taking statin drugs was associated with a 51% reduction in risk of colon cancer."
    (I know that short abstracts can often be taken out of context and suffer as a result.)

     
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