Results from a meta-analysis show patients treated with angiotensin-receptor blockers (ARBs) have an increased risk of developing a cancer.

The analysis published in The Lancet Oncology reported a small but significant increased risk of cancer among patients taking ARBs for treatment of hypertension, heart failure, diabetic nephropathy, and, recently, for cardiovascular risk reduction.

???We found that ARBs are associated with a modestly increased risk of new cancer occurrence.

???The finding of a 1.2 per cent increase in absolute risk of cancer over an average of four years needs to be interpreted in view of the estimated 41 per cent lifetime cancer risk.

???The increased cancer occurrence did not result in a significant excess in cancer deaths, although oncogenesis, tumour growth, and treatment failure followed by death is typically a slow process.

???Therefore, with the present trials, it is not possible to make conclusions regarding the effect of ARBs on cancer-related deaths,??? researchers said.

The first indication of a possible increase in cancer risk with ARBs was noted in the Candesartan in Heart failure Assessment of Reduction in Mortality and Morbidity programme (CHARM) in 2003.

???This trial reported a significant increase in risk of fatal cancers in patients randomised to candesartan compared with placebo [2.3 per cent vrs 1.6 per cent],??? the researchers said.

Further trials including other ARB drugs also noted an increased risk of cancer among patients.

In July last year a detailed briefing document on telmisartan was presented to the Food and Drugs Administration (FDA) Cardiovascular and Renal Drugs Advisory Committee, noting excesses in malignancies with telmisartan in two large scale studies.

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The Lancet Oncology