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December 8, 1989

The Purity of Cholestyramine Resin-Reply

JAMA. 1989;262(22):3128. doi:10.1001/jama.1989.03430220048013

In Reply.—  As pointed out in the original report of the Lipid Research Clinics Coronary Primary Prevention Trial results,1 the total incidence of fatal and nonfatal malignant neoplasms was similar in the cholestyramine resin and placebo groups. These incidence rates were somewhat lower than overall US cancer rates for comparably aged men. However, when the many different categories of malignancies were examined, the combined incidence of cancers of the mouth, pharynx, gastrointestinal tract, and pancreas was somewhat greater (21 vs 11 cases) in the cholestyramine resin group than in the placebo group. This excess incidence of gastrointestinal tract cancers was offset by reduced incidence of other cancers, particularly of the lung and prostate. The small numbers and multiple categories precluded firm conclusions, although the observation of excess cancers in the organ system directly exposed to cholestyramine resin was a matter of concern, especially in view of animal experiments in