This story reports on research, which while not definitive, is provocative. The story reports that new research found "that the very low levels of cholesterol achieved by high-dose statin therapy are associated with an increased risk of cancer." It did a good job of providing some insight on the limitations of the research reported on.
The story raises a question about the absolute merit of striving for ever lower LDL levels. It may help readers to see that statin use is a choice and that consumers should understand both the benefits and potential harms that may be associated with whatever pills they decide to take. However, it should be noted that study examined the prescribed dose levels of statins but did not really measure the effect of aiming for specific LDL levels. It would have been helpful to mention that the mechanism accounting for the increasing incidence of cancer is unclear.
The story did not contain any information about the costs of the various statin medications. Although not entirely germane to the main topic, since individuals might make choices about which specific statin to take based on claims of enhanced LDL lowering, it would seem that cost information should have been included.
For balance, an estimate of the benefit of statin use should have been presented. While the story did mention that statin medications provide benefit from heart disease, it did not provide any estimate for the magnitude of this benefit.
This story was about a possible harm (increased cancer incidence) that the statin medications may result in.
The story did a good job with respect to the evidence in that it reminded readers that ‘an association does not mean causation’. It would have been helpful, perhaps, to spend a little more time explaining this reasoning for those quick to jump on the bandwagon of such findings.
The risk for additional cancer cases being seen as the level of LDL decreased (1 per 1,000) was presented. The story described this as a ‘small’ risk, though it would have been useful to readers to provide some context (i.e. present data on the magnitude of some other, better known cancer risk factor increases cancer risk).
The story did mention that the results it reported on derive from a analysis of 10 randomized trials in which 41,173 patients taking statins were studied from up to six years.
The story did a bit of disease and treatment mongering. Describing these medications as ‘lifesaving pills’ which people take to protect themselves ‘against the ravages of heart disease’ sets a tone that is not conducive to helping readers think objectively about the research results being reported on.
The story did mention where the research was conducted and the journal in which it was published. However, it did not contain any obvious input from experts in the field.
The story did not comment on other means for lowering LDL cholesterol; this was not, however relevant to the main topic of the story, namely – the potential for increased incidence of cancer seen in individuals who lower their cholesterol.
The story contained estimates of how many people are currently taking statin medication.
The story included information that the observed association between LDL cholesterol level attained and cancer risk is something that has been previously reported.
The story did not include any quotes or comments from anyone either associated with the research or a recognized expert in the field so we can’t be sure if the story relied solely or largely on a news release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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