Case-control analysis within a UK primary care cohort: oral bisphosphonates and risk of cancer of oesophagus, stomach, and colorectum
Do these commonly prescribed drugs cause cancer?
Oral bisphosphonates are commonly used in the treatment of osteoporosis, Paget’s disease, myeloma, and metastatic bone disease. When drugs are widely used, it is important that side effects and potential complications of prolonged use are reported in medical literature to guide the need for further research and inform prescribing practice. Bisphosphonates are reasonably well tolerated, but gastrointestinal side effects ranging from mild gastric discomfort through to ulcer disease have been documented. In 2009, the possibility of a link between the use of bisphosphonates and oesophageal cancer was raised in a report of 54 adverse reaction case reports from the United States, Europe, and Japan received by the US Food and Drug Administration.1 Based on these cases, the authors of this study recognised the need for further epidemiological studies to confirm or refute the association between bisphosphonate use and oesophageal cancer.
Case-control studies sit further down the hierarchy of evidence than