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Low cholesterol levels linked with cancer

Patients who take statins to lower cholesterol could have a higher risk of developing cancer suggests new research published in the Journal of the American College of Cardiology (JACC).

Patients who take statins to lower cholesterol could have a higher risk of developing cancer, according to a new meta analysis published in the Journal of the American College of Cardiology (JACC).

The researchers were initially searching for a link between statins and known side-effects such as liver damage and muscle wasting but instead discovered an extra cancer case for every 1,000 patients treated.

The study examined patients treated with popular statins including Pfizer's Lipitor and Merck & Co's Zocor.

"The research is interesting but there is plenty of evidence to show that Lipitor in particular and [other] statins are very safe. The research is not something we are particularly concerned with as we are very confident of Lipitor's safety. The comment that the research is high positive generating [statistics] and not high positive proving is very interesting," said Andrew Thomas, spokesperson for Pfizer.

Researchers reviewed 13 previous trials involving 41,173 patients, which were all published before November 2005. Higher rates of cancer were detected among patients whose use of statins resulted in the lowest levels of LDL cholesterol.

"This analysis doesn't implicate the statin in increasing the risk of cancer," said lead author Richard H. Karas, M.D., F.A.C.C., professor of medicine at Tufts University School of Medicine. "The demonstrated benefits of statins in lowering the risk of heart disease remain clear; however, certain aspects of lowering LDL with statins remain controversial and merit further research."

Researchers assessed absolute change and percentage of change in LDL reduction and the resulting achieved LDL levels in relation to rates of newly diagnosed cancer in each treatment arm. They also looked at the relationship between low, intermediate and high doses of statins and rates of newly diagnosed cancer. Although they did not find a relationship between percent of change and absolute change in LDL levels, they observed higher rates of newly diagnosed cancer among patients with lower LDL levels. 

The new cancers detected were not dominated by any single form, which means if there is a connection between low levels of LDL cholesterol, it would have to apply to all cancers. The researchers themselves point out that the findings are not definitive, and have their limitiations.

The possibility has been raised that statins allow patients to live longer, and therefore they are more likely to develop cancer the older they get.

Researchers performed their analysis from summary data taken directly from published manuscripts of each trial. An analysis based on data for each individual patient would have yielded more specific and potentially more compelling results, said Dr. Karas. 

The results will be published in the July 31 issue of  JACC.

24th July 2007

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