0
January 3, 1996, Vol 275, No. 1 >
ARTICLE | January 3, 1996

Does Lowering Cholesterol Cause Cancer? FREE

James E. Dalen, MD, MPH; William S. Dalton, PhD, MD
[+] Author Affiliations

Reprint requests to Office of the Vice President for Health Sciences, University of Arizona College of Medicine, Tucson, AZ 85724 (Dr Dalen).


JAMA. 1996;275(1):67-69. doi:10.1001/jama.1996.03530250071030
Text Size: A A A
Published online
Article
References

Deciding who should be screened and treated for elevated cholesterol levels has profound implications for the health of our nation. Depending on the selection criterion for screening, the costs of screening and treatment and the potential savings by preventing myocardial infarction and death from coronary heart disease (CHD) can be staggering. The two extreme positions regarding the appropriate population to be screened and treated are those of the National Cholesterol Education Program (NCEP)1 and of Hulley and his associates.2 The NCEP recommends that all Americans aged 20 years and older be screened for high cholesterol and has prepared dietary and drug therapy guidelines for patients, millions of whom do not have clinical evidence of CHD. Since CHD is a progressive disease that may take decades to become manifest, the NCEP recommends primary as well as secondary prevention.

See also p 55.

Hulley and coworkers have reported that screening

REFERENCES

1 +
Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults.  Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). JAMA . 1993;;269:3015-3023.
2 +
Hulley SB, Walsh JMB, Newman TB.  Health policy on blood cholesterol: time to change directions. Circulation . 1992;;86:1026-1029.
3 +
Newman TB, Browner WS, Hulley SB.  The case against childhood cholesterol screening. JAMA . 1990;;264:3039-3043.
4 +
Hulley SB, Newman TB.  Cholesterol in the elderly: is it important? JAMA . 1994;; 272:1372-1374.
5 +
Kuller LH.  Sudden death: definition and epidemiologic considerations. Prog Cardiovasc Dis . 1980;;23:1-12.
6 +
Santiago JM, Dalen JE.  Cholesterol and violent behavior. Arch Intern Med . 1994;; 154:1317-1321.
7 +
Newman TB, Hulley SB.  Carcinogenicity of lipid-lowering drugs. JAMA . 1996;; 275:55-60.
8 +
Arky R, ed. Physicians' Desk Reference . 46th ed. Montvale, NJ: Medical Economics Data; 1992;.
9 +
Kritchevsky SB, Kritchevsky D.  Serum cholesterol and cancer risk: an epidemiologic perspective. Annu Rev Nutr . 1992;;12:391-416.
10 +
Sherwin RW, Wentworth DN, Cutler JA, et al.  Serum cholesterol levels and cancer mortality in 361662 men screened for the Multiple Risk Factor Intervention Trial. JAMA . 1987;;257:943-948.
11 +
Davey Smith G, Pekkanen J.  Should there be a moratorium on the use of cholesterol lowering drugs? BMJ . 1992;;304:431-434.
12 +
Law MR, Thompson SG, Wald NJ.  Assessing possible hazards of reducing serum cholesterol. BMJ . 1994;;308:373-379.
13 +
Committee of the Principal Investigators.  WHO cooperative trial on primary prevention of ischaemic heart disease with clofibrate to lower serum cholesterol: final mortality follow-up. Lancet . 1984;;2:600-604.
14 +
Pearce ML, Dayton S.  Incidence of cancer in men on a diet high in polyunsaturated fat. Lancet . 1971;;1:464-467.
15 +
Huttunen JK, Heinonen OP, Manninen V, et al.  The Helsinki Heart Study: an 8.5-year safety and mortality follow-up. J Intern Med . 1994;;235:31-39.
16 +
The Multiple Risk Factor Intervention Trial Research Group.  Mortality rates after 10.5 years for participants in the Multiple Risk Factor Intervention Trial: findings related to a priori hypotheses of the trial. JAMA . 1990;;263:1795-1801.
17 +
Canner PL, Berge KG, Wenger NK, et al.  Fifteen year mortality in coronary drug project patients: long-term benefit with niacin. Am J Cardiol . 1986;;8:1245-1255.
18 +
Lave LB, Ennever FK, Rosenkranz HS, Omenn GS.  Information value of the rodent bioassay. Nature . 1988;;336:631-633.
19 +
Ames BN, Magaw R, Gold LS.  Ranking possible carcinogenic hazards. Science . 1987;;236:271-280.
20 +
Tomatis L, Bartsch H.  The contribution of experimental studies to risk assessment of carcinogenic agents in humans. Exp Pathol . 1990;;40:251-266.
21 +
Gold LS, Sawyer CB, Magaw R, et al.  A carcinogenic potency database of the standardized results of animal bioassays. Environ Health Perspect . 1984;;58:9-319.
22 +
Gold LS, de Veciana M, Backman GM, et al.  Chronological supplement to the carcinogenic potency database: standardized results of animal bioassays published through December 1982. Environ Health Perspect . 1986;;67:161-200.
23 +
Gold LS, Slone TH, Stern BR, Manley NB, Ames BN.  Rodent carcinogens: setting priorities. Science . 1992;;258:261-265.
24 +
Ames BN, Gold LS, Willett WC.  The causes and prevention of cancer. Proc Natl Acad Sci U S A . 1995;;92:5258-5265.
25 +
Mordenti J.  Man versus beast: pharmacokinetic scaling in mammals. J Pharm Sci . 1986;;75:1028-1040.
26 +
Ames BN, Gold LS.  Chemical carcinogenesis: too many rodent carcinogens. Proc Natl Acad Sci U S A . 1990;;87:7772-7776.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults.  Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). JAMA . 1993;;269:3015-3023.
2 +
Hulley SB, Walsh JMB, Newman TB.  Health policy on blood cholesterol: time to change directions. Circulation . 1992;;86:1026-1029.
3 +
Newman TB, Browner WS, Hulley SB.  The case against childhood cholesterol screening. JAMA . 1990;;264:3039-3043.
4 +
Hulley SB, Newman TB.  Cholesterol in the elderly: is it important? JAMA . 1994;; 272:1372-1374.
5 +
Kuller LH.  Sudden death: definition and epidemiologic considerations. Prog Cardiovasc Dis . 1980;;23:1-12.
6 +
Santiago JM, Dalen JE.  Cholesterol and violent behavior. Arch Intern Med . 1994;; 154:1317-1321.
7 +
Newman TB, Hulley SB.  Carcinogenicity of lipid-lowering drugs. JAMA . 1996;; 275:55-60.
8 +
Arky R, ed. Physicians' Desk Reference . 46th ed. Montvale, NJ: Medical Economics Data; 1992;.
9 +
Kritchevsky SB, Kritchevsky D.  Serum cholesterol and cancer risk: an epidemiologic perspective. Annu Rev Nutr . 1992;;12:391-416.
10 +
Sherwin RW, Wentworth DN, Cutler JA, et al.  Serum cholesterol levels and cancer mortality in 361662 men screened for the Multiple Risk Factor Intervention Trial. JAMA . 1987;;257:943-948.
11 +
Davey Smith G, Pekkanen J.  Should there be a moratorium on the use of cholesterol lowering drugs? BMJ . 1992;;304:431-434.
12 +
Law MR, Thompson SG, Wald NJ.  Assessing possible hazards of reducing serum cholesterol. BMJ . 1994;;308:373-379.
13 +
Committee of the Principal Investigators.  WHO cooperative trial on primary prevention of ischaemic heart disease with clofibrate to lower serum cholesterol: final mortality follow-up. Lancet . 1984;;2:600-604.
14 +
Pearce ML, Dayton S.  Incidence of cancer in men on a diet high in polyunsaturated fat. Lancet . 1971;;1:464-467.
15 +
Huttunen JK, Heinonen OP, Manninen V, et al.  The Helsinki Heart Study: an 8.5-year safety and mortality follow-up. J Intern Med . 1994;;235:31-39.
16 +
The Multiple Risk Factor Intervention Trial Research Group.  Mortality rates after 10.5 years for participants in the Multiple Risk Factor Intervention Trial: findings related to a priori hypotheses of the trial. JAMA . 1990;;263:1795-1801.
17 +
Canner PL, Berge KG, Wenger NK, et al.  Fifteen year mortality in coronary drug project patients: long-term benefit with niacin. Am J Cardiol . 1986;;8:1245-1255.
18 +
Lave LB, Ennever FK, Rosenkranz HS, Omenn GS.  Information value of the rodent bioassay. Nature . 1988;;336:631-633.
19 +
Ames BN, Magaw R, Gold LS.  Ranking possible carcinogenic hazards. Science . 1987;;236:271-280.
20 +
Tomatis L, Bartsch H.  The contribution of experimental studies to risk assessment of carcinogenic agents in humans. Exp Pathol . 1990;;40:251-266.
21 +
Gold LS, Sawyer CB, Magaw R, et al.  A carcinogenic potency database of the standardized results of animal bioassays. Environ Health Perspect . 1984;;58:9-319.
22 +
Gold LS, de Veciana M, Backman GM, et al.  Chronological supplement to the carcinogenic potency database: standardized results of animal bioassays published through December 1982. Environ Health Perspect . 1986;;67:161-200.
23 +
Gold LS, Slone TH, Stern BR, Manley NB, Ames BN.  Rodent carcinogens: setting priorities. Science . 1992;;258:261-265.
24 +
Ames BN, Gold LS, Willett WC.  The causes and prevention of cancer. Proc Natl Acad Sci U S A . 1995;;92:5258-5265.
25 +
Mordenti J.  Man versus beast: pharmacokinetic scaling in mammals. J Pharm Sci . 1986;;75:1028-1040.
26 +
Ames BN, Gold LS.  Chemical carcinogenesis: too many rodent carcinogens. Proc Natl Acad Sci U S A . 1990;;87:7772-7776.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems