BoneKEy Reports | BoneKEy Watch

Bisphosphonate use does not increase risk of gastrointestinal cancer



DOI:10.1038/bonekey.2013.58

Analysis by Vinogradova et al of patient data from the QResearch primary care database (QR), which includes 660 GP practices in the UK, and the Clinical Practice Research Datalink (CPRD), which includes 643 GP practices, also in the UK, sought to clarify the association between bisphosphonate (BP) use and gastrointestinal cancers.

Cases of colorectal cancer (20 106 in the QR database and 19 035 in the CPRD), gastric cancer (3155 and 3157) and oesophageal cancer (5364 and 5135, respectively) were identified, and BP use by individual patients was noted. Use of any BP, involving at least one prescription, was not associated with increased risk of any gastrointestinal cancer; adjusted odds ratios varied between 0.79 and 1.44.

No evidence emerged of an increased risk of gastrointestinal cancer of any type for any individual BP, apart from alendronate. Patients who had taken alendronate had a slightly increased risk of gastric cancer (odds ratio 1.47, 95% confidence interval 1.11 to 1.95; P=0.008), but this was noted only in the QR database, not in CPRD.

Editor’s comment: Previous epidemiological studies have shown that oral BPs increase, decrease, or have no effect on the risk of digestive cancers, leaving us with some uncertainties. This large new analysis of many UK patients clearly shows no consistently modified digestive cancer risk among BP users. Let’s hope the debate is now closed.


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