LOS ANGELES — The use of angiotensin-converting enzyme inhibitors is associated with a significantly lower risk of developing esophageal, pancreatic, and colon cancers, according to research presented at the annual Digestive Disease Week.
Three case-control analyses of more than 480,000 veterans living in eight states in the south-central United States showed that patients who used ACE inhibitors were less likely to develop certain cancers. Patients taking ACE inhibitors were 53% less likely to develop colon cancer, 52% less likely to develop pancreatic cancer, and 46% less likely to develop esophageal cancer than patients who did not take the drugs.
ACE inhibitors may exert this risk-reduction effect by suppressing vascular endothelial growth factor (VEGF), which many researchers believe plays a significant role in the angiogenesis of human tumors, said lead study author Dr. Vikas Khurana of the Overton Brooks VA Medical Center in Shreveport, La. Dr. Khurana is on the speakers' bureau for AstraZeneca.
Dr. Khurana and his colleagues performed three retrospective analyses of the Veterans Integrated Service Network 16 database, looking at 483,733 patients who made regular visits to a VA medical center clinic from October 1998 to June 2004.
Of those patients, 184,743 (38%) were using ACE inhibitors. A total of 6,697 patients in the VA database (1.5%) had colon cancer, 475 patients (0.1%) had pancreatic cancer, and 659 patients (0.14%) had esophageal cancer.
The data were adjusted for age, race, gender, body mass index, smoking, alcohol use, diabetes, and statin use. The protective effect of ACE inhibitor use was independent of statin use for all three cancers, Dr. Khurana said. However, the investigators did not factor the dose, duration, or type of ACE inhibitor into their analysis.
But Dr. Khurana does not recommend a change in prescribing patterns based on the results of this study, since it was a case-control analysis. “We need to have randomized controlled trials before we use these agents as chemopreventive agents,” he said.