Bisphosphonate use is associated with an increased risk of cancer, with the effect particularly strong in women rather than men, according to new research on a UK cohort.
Researchers from London found a 13% increased risk for upper gastrointestinal cancer in those who had taken bisphosphonates compared with patients who had not.
The study included 8,636 men and women who had a recorded incident of upper gastrointestinal cancer, matched to 34,544 controls with no record of upper gastrointestinal cancer. Bisphosphonate use was defined as any patient ever prescribed one during the 13-year study period.
Women taking bisphosphonates had a 34% increased risk of cancer, adjusted for smoking status, compared with controls, whereas men experienced a 19% decrease in risk.
When they restricted analysis to look at oesophageal cancer alone, they found a 43% increase in risk for women who had taken bisphosphonates, compared with controls. For men there was a 13% decrease compared with controls.
The researchers concluded: ‘In the presence of an association and with a plausible mechanism to account for possible causation, it would be sensible to exercise caution in prescribing bisphosphonates to patients with pre-existing risk factors for upper gastrointestinal cancer.’
PLOS One 2012, online 24 October