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23-01-2013 | General practice | Article

Bisphosphonate cancer scare over?


BMJ 2013; 346: f114

medwireNews: Latest research may put to rest concerns of an increased gastrointestinal cancer risk associated with bisphosphonate use.

The study, published in the BMJ, analysed data from the QResearch primary care database and the Clinical Practice Research Datalink (previously known as the General Practice Research Database; GPRD) of patients aged 50 years or over with a diagnosis of gastrointestinal cancer during 1997-2011. It included 28,625 and 27,324 cases of gastrointestinal cancers in each database, respectively, matched to controls.

After adjusting for confounders, such as smoking, alcohol consumption and other medications, the authors found no association in either database between a history of bisphosphonate prescription and risk of oesophageal, gastric or colorectal cancer.

Only in the QResearch database was short-term alendronate use (<12 months) linked to a 91% increase in the odds of gastric cancer compared with no bisphosphonate use. However, the authors say this is unlikely to reflect a causal relationship as there was no association with use longer than a year.

Previous studies of the association have been smaller and produced conflicting results, say authors Dr Yana Vinogradova and colleagues from the University of Nottingham. An earlier nested case-control study of the GPRD found an association between bisphosphonate use and oesophageal cancer but this was not replicated in other studies.

Dr Pam Brown, GP and specialist doctor in osteoporosis, in Swansea, said that she found the results of the latest study reassuring.

"The risk-benefit profile of these drugs in preventing fractures in those with osteoporosis has always been positive and they form the mainstay of treatment as they are effective in reducing future fracture risk," Dr Brown told Univadis Medical News.

medwireNews is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Kirsty Oswald