Bisphosphonates and risk of cancers: a systematic review and meta-analysis

Abstract

Background It is unclear whether bisphosphonates are associated with risk of cancers. Therefore, this meta-analysis aimed to evaluate the effect of bisphosphonates on overall cancers. Methods A search in Pubmed, Embase, Cochrane Library and Web of Science databases was conducted, from the inception date of each resource to September 26, 2019. The summarised effect estimates with 95% CIs were calculated using a random-effect model. Heterogeneity and publication bias were explored. Results Thirty-four articles were included in this study (4,508,261 participants; 403,196 cases). The results revealed that bisphosphonates significantly decreased the risk of colorectal cancer (RR = 0.89, 95% CI: 0.81–0.98), breast cancer (RR = 0.87, 95% CI: 0.82–0.93) and endometrial cancer (RR = 0.75, 95% CI: 0.61–0.94), but no significant association was observed in all-cause cancer. Furthermore, nitrogen-containing bisphosphonates only had protective effects both on breast cancer (RR = 0.94, 95% CI: 0.90–0.99) and endometrial cancer (RR = 0.70, 95% CI: 0.54–0.92). Non-nitrogen-containing bisphosphonates tended to increase the risk of liver cancer (RR = 2.14, 95% CI: 1.23–3.72) and pancreas cancer (RR = 1.75, 95% CI: 1.32–2.33). Conclusion Bisphosphonates are significantly associated with risk reduction of colorectal, breast and endometrial cancer, especially nitrogen-containing bisphosphonates. It should be noted that non-nitrogen-containing bisphosphonates might increase the risk of liver and pancreas cancer. Large prospective cohort studies are needed to find the causal association between bisphosphonates and risk of cancers.

Phenolic Phytochemicals for Prevention and Treatment of Colorectal Cancer: A Critical Evaluation of In Vivo Studies

“…(RR = 0.89, 95% CI: 0.81-0.98) [119] Abbreviations: RCT, randomized control trial; RR, relative risk; HR, hazard ratio; OR, odds ratio, AOR, adjusted odds ratio; CI, confidence interval; DFMO, difluoromethylornithine; UCDA, ursodeoxycholic acid.…”

Guías de práctica clínica en la osteoporosis postmenopáusica, glucocorticoidea y del varón (actualización 2022)

“…2022;14(1):13-33 ORIGINALS cular events, and a reduction in the incidence of some cancers. However, the actual extent of these effects remains controversial [74][75][76] . a) Adverse effects on the upper digestive tract have been described in patients taking oral BPs (i.e., esophagitis and esophageal ulcers).…”

A Review of Literature on Updates of Bisphosphonates Administration, Cancer Biomarkers for Bisphosphonate Therapy, and Bisphosphonate-related Osteonecrosis of the Jaw in Breast Cancer

“…Li et al (14), with this belief that it is not obvious whether bisphosphonate is related to the risk of cancers, conducted a meta-analysis efforted at evaluating the effect of bisphosphonates on overall cancers. Their results show that bisphosphonates significantly decreased the risk of colorectal cancer, breast cancer, and cancers of endometrium, but no significant association was observed in cancers with all-causes.…”

“…Li et al (14) in 2020 published a systematic review and concluded that especially nitrogen-containing bisphosphonates significantly decreased the risk of colorectal, breast and endometrial cancer. They also found that bisphosphonates without nitrogen might increase the risk of liver and pancreas cancer.…”