BoneKEy Reports | BoneKEy Watch
Alendronate decreases upper GI cancer death risk
DOI:10.1038/bonekey.2012.17
The relationship between bisphosphonate use and the risk of death due to upper GI cancer is uncertain. Studies have failed to differentiate whether bisphosphonate users have a higher risk of oesophageal or gastric cancer, or whether they have a higher rate of detection because of more frequent endoscopy.
Abrahamsen and colleagues performed an open cohort study using the Danish National Prescription Database (NPD), the Cause of Death register (CoDR) and the National Hospital Discharge Register to provide clarification. The frequency of upper endoscopy, oesophageal cancer incidence, gastric cancer incidence and upper GI cancer-specific mortality was compared between over 30 000 female alendronate users and over 120 000 matched controls.
Alendronate users had a significantly lower risk of developing gastric cancer and no increased risk of developing oesophageal cancer; both effects were greater after more than 10 years of alendronate therapy. The risk of oesophageal cancer death was reduced in women taking alendronate for three years.
Editor's comment: This large, register-based observational study provides reliable evidence that the risk of gastric and oesophageal cancer is not increased by bisphosphonates. Cancer deaths actually decreased in the first few years of medication due to a higher rate of endoscopy. These data are reassuring and should help balance some recent negative media reports.
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