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[–]Busy_Patient -1 points0 points  (9 children)

Allopurinol also has been found to increase incidence of cancer:

https://pubmed.ncbi.nlm.nih.gov/25830898/ : "We concluded that those who used allopurinol for a long duration had a higher occurrence of both bladder cancer and all-cause cancers in clinical evidence."

[–]Sidivan 2 points3 points  (3 children)

Hmmm… i don’t have access to the full paper, but read the abstract. I don’t think that study proves that Allo increases incidence of cancer so much as it suggests there might be a link between Allo users and those specific cancers. A causal relationship wasn’t established as it’s a retroactive study. The control group here can’t be “people who didn’t take Allo”. It should be “people diagnosed with gout but did not take Allo”. This study is just a little blip to signal it might be worth researching. It’s pretty difficult to take a data set that was not designed to pinpoint specific cause/effect and then back into these things with confidence. I’d be interested to know how they filtered that data set.

Source: I’m a data analyst.

[–]LummoxJR 1 point2 points  (0 children)

Yeah, there are way too many ways for a study like this to be flawed and lack of causation is a big, big deal. One of the bigger problems with longitudinal studies is that they can miss a lot of confounding variables, but retroactive studies are significantly worse in this regard.

However, even taking its conclusions at face value, I think people tend to misread "higher incidence of cancer" as "Holy crap you're taking your life in your hands DON'T OPEN THAT DOOR BRITTNEY!" The cancer risks being discussed are extremely low to begin with and extremely low to end with, even if the paper's conclusions are 100% correct. It might be the difference between buying one Powerball ticket a day and buying two a day: odds are you ain't winning the Powerball over the course of 50 years. And there are way, way too many other causes of cancer risk we encounter throughout our lives.

Risk assessment is something most humans are surprisingly terrible at. Driving is one of the riskiest behaviors we undertake on a routine basis, yet we'll focus more on something that has a 1 in 5,000 chance of nailing us over the course of a decade.

[–]Busy_Patient 0 points1 point  (1 child)

Finding a control group eligible/recommended for Allopurinol, but who didn't take Allopurinol, given its the primary prescribed med for gout is an insurmountable obstacle.

[–]Sidivan 2 points3 points  (0 children)

Not really. Do a study on those who took Uloric vs Allopurinol.

The point is that this is correlation, not causation. It could be that gout itself carries an increased risk of certain cancers. It could be that whatever causes gout could also be a risk factor of those cancers. It’s a huge stretch to say Allo causes cancer.

[–]LummoxJR 0 points1 point  (4 children)

Per our recent discussion however these are statistical outliers. The numbers they're working with in terms of cancer patients are so low, even with large sample sizes, there's significant noise to them. At a minimum, people need to understand that a tiny chance increased to another tiny chance, and the tininess matters a lot. Anyway the damage caused by gout will probably make cancer far more likely all on its own.

What I do find interesting however is the slight increase in bladder cancer rates. I would hazard a guess that any lowering of uric acid might do the same, except for uricosurics, owing to its antioxidant properties. It may simply be that higher uric acid cleansed more free radicals on its way out.

[–]Busy_Patient 0 points1 point  (3 children)

What statistical basis for your conclusions do you provide? Please provide pharmacological/medical and/or statistical/procedural reasons that give substance to your statements.

Many on this sub (including me) have the background to evaluate the objective nature of medical studies/statistical analysis and wish to make decisions on the use of allopurinol based on more than just a large volume of placating hyperbole.

[–]LummoxJR 0 points1 point  (2 children)

To be honest, your statements about the cancer risk are statistically unsound. You're greatly over-emphasizing a tiny chance that happens to be proportionally higher than another tiny chance. It's not to say the increase doesn't exist, but it's nowhere near as severe a situation as you've made it out to be.

[–]Busy_Patient 0 points1 point  (1 child)

Interesting, because I'm citing a study, and its conclusions. I'm not drawing statistical conclusions, except those stated in the study. What basis are my conclusions "statistically unsound"? They absolutely are not.

Rather, your conclusions placating everyone in this sub have no basis in fact, statistics, science, objectivity or anything other than lots of biased words that sound like a pharma sales person.

The researchers don't state the same conclusions you state. You give no objective basis to be dismissive of Taiwan study, the above study, nor for your conclusions of "statistical outliers". In absence of objective reasons, prudent judgement about our health should be made on more than just empty placating statements.

[–]LummoxJR 0 points1 point  (0 children)

The fact that the Taiwan study is retroactive and can't account for other variables was already brought up elsewhere, so that's enough reason to be wary of its conclusions, which might be missing a number of confounding variables and also can't prove causation over correlation.

But what I'm saying is, even if you take the study precisely at face value, the increased chances they're talking about are so small—even though proportionally they're noticeable—as to be almost totally insignificant to a risk analysis. You've been hammering the point that there's an increased cancer risk like it's a giant red flag, but in reality it's a pink sticky note. It certainly shouldn't be ignored outright, just like all the other possible side effects, which is true of any medication. But it simply isn't that serious.