Bisphosphonate exposure not linked to esophageal cancer

There appears to be no association between the use of oral bisphosphonates and the risk of esophageal or gastric cancer, according to research published in the Aug. 11 issue of the Journal of the American Medical Association, as reported by HealthDay News.

Chris R. Cardwell, PhD, of Queen’s University Belfast in the United Kingdom, and colleagues examined data on 41,826 patients receiving oral bisphosphonates and the same number of controls over a mean follow-up of about 4.5 years.

Researchers found 116 and 115 esophageal or gastric cancers in the treatment group and control group, respectively. Researchers found no difference between the groups in risk for esophageal and gastric cancers combined for any bisphosphonate use, and no difference in risk for either of the 2 cancers according to duration of use.

“[Oral bisphosphonates] should not be withheld, on the basis of possible esophageal cancer risk, from patients with a genuine clinical indication for their use,” the authors wrote.

Dr Cardwell told Formulary there were fears, particularly from case reports published in New England Journal of Medicine, that bisphosphonates may be associated with an increased risk of esophageal cancer. “Our study, which has weaknesses but is the largest study to date, suggests that there is no increase in esophageal cancer risk in individuals taking bisphosphonates,” Dr Cardwell said.

According to Dr Cardwell, the weakness of the study stems from incomplete information on individual characteristics, such as smoking and alcohol intake, and the study contained relatively small numbers of individuals who had been using bisphosphonates for a very long period of time (eg, 10-plus years). “It would be further reassuring if a study, which included many such individuals and had complete information on these individual characteristics were conducted,” Dr Cardwell said.