Oral bisphosphonates and esophageal cancer

January 01, 0001

Oral bisphosphonates and esophageal cancer

Oral bisphosphonates are widely used for the treatment of osteoporosis, but concerns have been raised regarding esophageal cancer. These UK and US researchers investigated the association between bisphosphonate use and esophageal cancer via extracting data from the UK General Practice Research Database to compare the incidence of esophageal cancer in a cohort of patients treated with oral bisphosphonates with incidence in a control cohort. Cox proportional hazards modeling was used to determine hazard ratios and 95% confidence intervals for risk of esophageal cancer in bisphosphonate users compared with nonusers, with adjustment for potential confounders.

The researchers report: "Hazard ratio for the risk of esophageal and gastric cancer in the bisphosphonate users compared with the bisphosphonate nonusers. Mean follow-up time was 4.5 and 4.4 years in the bisphosphonate and control cohorts, respectively. Excluding patients with less than 6 months' follow-up, there were 41,826 members in each cohort (81% women, mean age 70.0 years). One hundred sixteen esophageal or gastric cancers (79 esophageal) occurred in the bisphosphonate cohort and 115 (72 esophageal) in the control cohort. The incidence of esophageal and gastric cancer combined was 0.7 per 1000 person-years of risk in both the bisphosphonate and control cohorts. The incidence of esophageal cancer alone in the bisphosphonate and control cohorts was 0.48 and 0.44 per 1000 person-years of risk, respectively. There was no difference in risk of esophageal and gastric cancer combined between the cohorts for any bisphosphonate use (adjusted hazard ratio, 0.96) or risk of esophageal cancer only (adjusted hazard ratio, 1.07). There also was no difference in risk of esophageal gastric cancer by duration of bisphosphonate intake."

The researchers concluded: "Among patients in the UK General Practice Research Database, the use of oral bisphosphonates was not significantly associated with incident esophageal or gastric cancer."

This large study finds no evidence of a link between oral bisphosphonate use and esophageal cancer.

For the full abstract, click here.

JAMA 304(6):657-663, 11 August 2010
© 2010 American Medical Association
Exposure to Oral Bisphosphonates and Risk of Esophageal Cancer. Chris R. Cardwell, Christian C. Abnet, Marie M. Cantwell, Liam J. Murray.

Category: D. Digestive, M. Musculoskeletal. Keywords: bisphosphonates, osteoporosis, osteopenia, espophageal cancer, gastric cancer, cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 24 August 2010

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