This is the single most important concern with any telomerase-activating intervention, and it deserves a thorough answer.
You're correct that ~85-90% of human cancers upregulate telomerase (via hTERT expression) to maintain telomere length and achieve replicative immortality. So the question "could exogenous telomerase activation promote cancer?" is entirely legitimate.
The counterarguments:
- Telomerase activation alone is not sufficient for malignant transformation. Cancer requires multiple hallmark capabilities (evasion of growth suppressors, sustained proliferative signaling, resistance to apoptosis, etc.). Telomere maintenance is just one piece of a complex puzzle.
- Short telomeres may actually increase cancer risk. Critically short telomeres cause genomic instability (chromosome fusions, breakage-fusion-bridge cycles) which can initiate carcinogenesis. There's epidemiological evidence that shorter telomeres are associated with higher cancer incidence in some studies.
- Khavinson's animal studies reported no increase in tumor incidence. In fact, the Anisimov et al. (2003) study in mice showed a non-significant trend toward reduced tumor incidence in the treated group.
However, I want to be intellectually honest: the absence of evidence is not evidence of absence. Long-term safety data on telomerase-activating compounds in humans simply doesn't exist. If you have a personal or family history of cancer, extra caution is warranted.