ACE Inhibitors May Reduce Esophageal Cancer Incidence

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New research presented in Los Angeles at Digestive Disease Week 2006 (DDW) indicates that ACE inhibitors not only effectively lower blood pressure, but they also may be associated with a significant decrease in risk of developing 3 types of cancers: esophageal, pancreatic, and colon.

Researchers from the Overton Brooks Veterans’ Administration Medical Center and Louisiana State University Health Sciences Center in Shreveport, Louisiana, completed 3 case-controlled studies examining the relationship between ACE inhibitor use and incidence of esophageal, pancreatic, and colon cancer. Using a retrospective case control design, the team analyzed data from the Veterans’ Integrated Service Network (VISN 16) database, a resource tool containing clinical and demographic information about all veterans (>1.4 million) cared for in the 8-state South Central VA Health Care Network from October 1998 to June 2004.

Among the 483,733 patients in the study, 659 had esophageal cancer, 475 had pancreatic cancer, and 6697 had colorectal cancer; approximately 38% were taking ACE inhibitors. Patients were placed in the ACE inhibitor user group if they had used these agents prior to their cancer diagnosis.

While ACE inhibitors were associated with a reduction in risk for all 3 of the cancer types, they were most effective in lowering the likelihood of developing esophageal cancer, with a 55% reduction in incidence. Results also showed that ACE inhibitor use conferred a 48% reduced risk of pancreatic cancer and a 47% reduced risk of colon cancer.

The researchers believe the potential benefit of ACE inhibitors may be due to the suppression of tumor angiogenesis by blocking vascular endothelial growth factor (VEGF), which plays an important role in tumor angiogenesis. ACE inhibitors have been noted to suppress tumor growth by inhibiting tumor angiogenesis in several animal and experimental models.

The studies were controlled for age, race, gender, body mass index, smoking, alcohol use, reflux, NSAID use, statin use, and diabetes. However, dosage, duration, and type of ACE inhibitor used were not factored into the analyses.

“The limitations of our data are the VA population, the database and the fact that this is a case-control study,” the researchers state.

DDW is the largest international gathering of physicians, researchers, and academic physicians in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery. It is jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT). The annual meeting showcases more than 5000 abstracts and hundreds of lectures on the latest advances in GI research, medicine, and technology.