A Higher Dosage of Oral Alendronate Will Increase the Subsequent Cancer Risk of Osteoporosis Patients in Taiwan: A Population-Based Cohort Study

Lee, Wen Yuan; Sun, Li; Lin, Ming-Tzer; Liang, Ji An; Chang, Shih Ni; Sung, Fung Chang; Muo, Chih Hsin; Kao, Chia Hung

doi:10.1371/journal.pone.0053032

Cited by 24 publications

(38 citation statements)

References 21 publications

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“…To assess any association between the duration of bisphosphonate use and the risk of endometrial cancer, we used the available data from three cohort studies and two case–control studies . Results showed no risk reduction in the shortest bisphosphonate exposure (less than 1 year) (RR 0.92, 95%CI 0.64–1.34).…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies [13][14][15][16][17][18]30 met the inclusion criteria and were included in this meta-analysis ( Figure 1), including four cohort studies [14][15][16]18 and three case-control studies. 13,17,30 .…”

Section: Identification and Characteristics Of Studiesmentioning

confidence: 99%

“…In the overall analysis of the selected studies [13][14][15][16][17][18]30 , the use of bisphosphonate was significantly associated with a 25% decrease in the risk of endometrial cancer using a random-effects model (pool RR 0.75, 95%CI 0.60-0.94, p = 0.064, I 2 = 49.6%). To examine the consistency across varying study designs with different potential biases, we stratified data into subgroups on the basis of study design.…”

Section: Meta-analysis Of Exposure To Bisphosphonate and Endometrial mentioning

confidence: 99%

“…11,12 Recently, the association between endometrial cancer and the use of bisphosphonate was observed in several observational studies, suggesting that bisphosphonate might also be associated with reduced risk of endometrial cancer [13][14][15] , while other studies reported no identified effects. [16][17][18] One study reported that bisphosphonate use for more than one year significantly lowered the risk of endometrial cancer. 13 However, the existing results are controversial.…”

Section: Introductionmentioning

confidence: 99%

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Bisphosphonate use and the risk of endometrial cancer: a meta‐analysis of observational studies

Chiu

Wong

et al. 2016

Pharmacoepidemiology and Drug

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Section: Resultsmentioning

confidence: 99%

Section: Identification and Characteristics Of Studiesmentioning

confidence: 99%

Section: Meta-analysis Of Exposure To Bisphosphonate and Endometrial mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bisphosphonate use and the risk of endometrial cancer: a meta‐analysis of observational studies

Chiu

Wong

et al. 2016

Pharmacoepidemiology and Drug

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“…Our finding of reduced gastric cancer incidence among bisphosphonate users was replicated by several other studies, including one which found a 39% reduction in the risk of gastric cancer, although a recent meta‐analysis reported no overall effect . Several studies investigating the effect of bisphosphonate use on cancer incidence, separately for both the oesophageal and gastric sites, reported a similar pattern to our study ( i.e ., increased risk of oesophageal cancer which was largely offset by a decreased risk of gastric cancer) …”

Section: Discussionmentioning

confidence: 97%

The effect of medications which cause inflammation of the gastro‐oesophageal tract on cancer risk: a nested case–control study of routine Scottish data

Busby

Murchie

Murray

et al. 2017

Intl Journal of Cancer

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Novelty and Impact: This is the first study to investigate the impact of tetracyclines and spironolactone use on gastro-oesophageal cancer risk. Our findings should provide considerable reassurance to the many GPs and patients prescribing or taking these medications. Previous evidence around the effect of bisphosphonates on gastro-oesophageal cancer risk is mixed. Our work provides further evidence of no association, and could suggest that previous findings of positive associations might have been impaired by ascertainment bias. Abstract (Structured)Purpose: Bisphosphonate, tetracycline and spironolactone use has been shown to increase gastrooesophageal inflammation, an accepted risk factor for cancer. We explore whether use of these medications is associated with an increased risk of gastro-oesophageal cancer. Methods:A nested case-control study was conducted using the Primary Care Clinical Information Unit Research (PCCIUR) database from Scotland. Cases with oesophageal or gastric cancer between 1999 and 2011 were matched to up to five controls based on age, gender, year of diagnosis and general practice. Medication use was ascertained using electronic prescribing records. Conditional logistic regression was used to calculate odds ratios (ORs) for the association between medication use and cancer risk after adjustment for comorbidities and other medication use.Results: A similar proportion of gastro-oesophageal cancer cases received bisphosphonates (3.9% vs.3.5%), tetracycline (6.0% vs. 6.0%) and spironolactone (1.4% vs. 1.1%) compared with the controls. Conclusions:There is little evidence that that the use of bisphosphonate, tetracycline or spironolactone is associated with increased risk of gastro-oesophageal cancer. Our findings should reassure GPs and patients that these widely-used medications are safe with respect to gastrooesophageal cancer risk. Abstract (Unstructured)Bisphosphonate, tetracycline and spironolactone use has been shown to increase gastrooesophageal inflammation, an accepted risk factor for cancer. However, evidence on the effect of these medications on gastro-oesophageal cancer risk are mixed or missing entirely. Therefore, we conducted a nested case-control study using the Primary Care Clinical Information Unit Research (PCCIUR) database from Scotland. Cases with oesophageal or gastric cancer between 1999 and 2011 were matched to up to five controls based on age, gender, year of diagnosis and general practice.Medication use was ascertained using electronic prescribing records. Conditional logistic regression was used to calculate odds ratios (ORs) for the association between medication use and cancer risk after adjustment for comorbidities and other medication use.A similar proportion of gastro-oesophageal cancer cases received bisphosphonates (3.9% vs. 3.5%), tetracycline (6.0% vs. 6.0%) and spironolactone (1.4% vs. 1.1%) compared with the controls. The that that the use of bisphosphonate, tetracycline or spironolactone is associated with increased risk of gastro-oesophageal cancer. ...

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Bisphosphonates and risk of oesophageal cancer: A meta‐analysis

Zhong

2020

GastroHep

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Summary Background Nowadays, the use of bisphosphonates is common. Bisphosphonates play an important role in the therapy and precaution of osteoporosis. The use of bisphosphonates may have concerned with cancer, especially oesophageal and gastric cancer. Nevertheless, whether bisphosphonates would cause oesophageal cancer have not been determined. Methods Two investigators independently selected correlative studies via PubMed, Embase and Cochrane Database in February 2020. No language restriction in our searched strategy. The random effects were used to calculate the pooled odds ratio (OR) and 95% confidence intervals (CI) for the risk of oesophageal cancer in bisphosphonate users compared with non‐users and the adjusted effect size would be used to calculate the combined effect size. We utilised the Egger's regression model to qualify publication bias. The sensitivity analyses were performed in our study to examine the stability of the results. We proceeded in a particular meta‐analysis of observational studies in the relationship between bisphosphonates or alendronate and carcinoma of the oesophagus. Result Finally, there were 10 studies being included in our meta‐analysis. Among them, there were six nested case‐control studies and four cohort studies. Preliminary analysis showed that the use of bisphosphonates was not associated with oesophageal cancer in both nested case‐control group (OR 1.07, 95% CI 0.92‐1.23) and cohort study (OR 0.82, 95% CI 0.63‐1.06). There was no heterogeneity in cohort studies or nested case‐control studies. No significant OR was found in the analyses of continents, women, alendronate and histologic types of oesophageal carcinoma. Conclusion According to the current analysis, the use of bisphosphonates was not associated with the development of oesophageal cancer.

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A Higher Dosage of Oral Alendronate Will Increase the Subsequent Cancer Risk of Osteoporosis Patients in Taiwan: A Population-Based Cohort Study

Cited by 24 publications

References 21 publications

Bisphosphonate use and the risk of endometrial cancer: a meta‐analysis of observational studies

Bisphosphonate use and the risk of endometrial cancer: a meta‐analysis of observational studies

The effect of medications which cause inflammation of the gastro‐oesophageal tract on cancer risk: a nested case–control study of routine Scottish data

Bisphosphonates and risk of oesophageal cancer: A meta‐analysis

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