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Exposure to bisphosphonates and risk of gastrointestinal cancers

This week's publication of the British Medical Journal examines exposure to bisphosphonates and risk of gastrointestinal cancers.

News image

Dr Yana Vinogradova and colleagues investigated the association between use of bisphosphonates estimated from prescription information and risk of gastrointestinal cancers.

The team evaluated General practices in the United Kingdom contributing to the QResearch primary care database and the Clinical Practice Research Datalink.

Patients aged 50 with a diagnosis of a primary gastrointestinal cancer in 1997-2011, each matched with up to 5 controls by age, sex, practice, and calendar year.

The team's main outcome measures included odds ratios for incident gastrointestinal cancers and use of bisphosphonates, adjusted for smoking status, ethnicity, comorbidities, and use of other drugs.

The research team noted that results 20,106 and 19,035 cases of colorectal cancer cases, 5364 and 5135 cases of esophageal cancer cases, and 3155 and 3157 cases of gastric cancer were identified from QResearch and Clinical Practice Research Datalink, respectively.

Bisphosphonate use was not associated with risk of colorectal cancers in either database
British Medical Journal

Overall bisphosphonate use was not associated with risk of colorectal, oesophageal, or gastric cancers in either database.

The doctors assessed that adjusted odds ratios for QResearch and Clinical Practice Research Datalink  were 0.97 and 1.2 for esophageal cancer; 1.1 and 0.8 for gastric cancer; and 1 and 1.1 for colorectal cancer.

Additional analyses showed no difference between types of bisphosphonate for risk of oesophageal and colorectal cancers.

Dr Vinogradova's team commented, "For gastric cancer, alendronate use was associated with an increased risk, but only in data from the QResearch database and without any association with duration and with no definitive confirmation from sensitivity analysis."

"In this series of population based case-control studies in 2 large primary care databases, exposure to bisphosphonates was not associated with an increased risk of common gastrointestinal cancers."

BMJ 2013; 346: f114
15 February 2013

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