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Bisphosphonates May Raise Esophageal Cancer Risk

Use over five years associated with doubled risk of developing esophageal cancer

FRIDAY, Sept. 3 (HealthDay News) -- Oral bisphosphonate use over five years may double one's risk of developing esophageal cancer, according to a study published online Sept. 2 in BMJ.

In a nested case-control analysis within a primary care cohort, Jane Green, M.D., of the University of Oxford in the United Kingdom, and colleagues evaluated adults, 40 years of age and older, with esophageal cancer, gastric cancer, and colorectal cancer diagnosed between 1995 and 2005. Each case was matched with five controls.

The investigators found that the incidence of esophageal cancer was higher among individuals with at least one previous prescription for oral bisphosphonates than for those without any bisphosphonate prescriptions (relative risk [RR], 1.30). The risk of esophageal cancer was also significantly higher for 10 or more prescriptions (RR, 1.93) than for one to nine prescriptions (RR, 0.93). In addition, the risk of esophageal cancer was significantly higher for use for over three years (on average, approximately five years) compared to no bisphosphonate use (RR, 2.24). Gastric and colorectal cancers were not associated with use of bisphosphonate prescriptions.

"The possibility of adverse effects on the esophagus should prompt doctors who prescribe these drugs to consider risks versus benefits, to ask patients about digestive disorders before prescribing, and to reinforce directions on the basis of the individual product with each prescription," writes the author of an accompanying editorial.

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