Exposure to oral bisphosphonates and risk of gastrointestinal cancer

Choi, D.; Choi, S.; Chang, J.; Park, S. M.

Affiliations

¹Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea

²Pyeongchang Health Center and County Hospital, Pyeongchang, South Korea

³Department of Family Medicine, Seoul National University Hospital, Seoul, South Korea

Abstract and keywords

Summary: Few studies have explored the association of oral bisphosphonate exposure and gastrointestinal cancer within Asian populations. In this study, we investigated 45,397 Korean women from the nationwide population-based cohort from 2002 to 2013. Oral bisphosphonate exposure did not appear to be associated with elevated or reduced risk for gastrointestinal cancer.

Introduction: While several studies suggested increased risk in upper gastrointestinal (GI) cancer or reduced risk in colorectal cancer upon bisphosphonate exposure, the association is less explored within Asian populations. We investigated the effect of oral bisphosphonate exposure on the risk of GI cancers within a nationwide population-based cohort.

Methods: This study used two separate cohorts. The first cohort included 45,397 women aged 60 years or older from the National Health Insurance Service-Health Screening Cohort during 2002–2013. Participants were classified into bisphosphonate users and non-users based on drug exposure during 2002–2007, and followed-up from the index date of January 1, 2008. The second cohort included 25,665 newly diagnosed osteoporosis patients who started taking oral bisphosphonate during 2003–2008. After 4 years of drug exposure period, patients were separated into quartiles based on cumulative oral bisphosphonate exposure. Participants were followed-up until December 31, 2013 for GI cancer, stomach cancer, and colorectal cancer. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) for the cancer risks.

Results: Compared to bisphosphonate non-users, no significant risk difference was observed among bisphosphonate users on GI (HR 1.06; 95% CI 0.87–1.28), stomach (HR 1.11; 95% CI 0.85–1.47) and colorectal cancers (HR 1.04; 95% CI 0.79–1.37). Among bisphosphonate users, increasing doses of bisphosphonate exposure was not associated with elevated or reduced risk for GI cancer (p for trend 0.573).

Conclusion: Oral bisphosphonate use did not appear to be associated with elevated or reduced risk for GI cancers.

Keywords: Bisphosphonate; Colorectal cancer; Gastrointestinal cancer; Stomach cancer

Links

DOI: 10.1007/s00198-020-05327-x

PubMed: 32034451

WoS: 000516153600002

History

Received: 2019-09-19

Accepted: 2020-01-30

Online: 2020-02-07

Cited Works (1)

Year	Entry
2014	Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, Dawson‐Hughes B. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res. November 2014;29(11):2520-2526.