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Osteoporosis Drugs no Risk for Esophageal Cancer in Large Study

Kathleen Blanchard's picture

Some studies have linked osteoporosis drugs to increased risk of esophageal and gastric cancer. A study of 80,000 patients in the United Kingdom shows no link between the drugs, known as bisphosphonates and esophageal cancer.

The findings come from an analysis of data from the UK General Practice Research Database. Researchers say though osteoporosis drugs can cause inflammation of the esophagus, known as esophagitis, the link between esophageal and gastric cancer has been suggested but never vigorously investigated.

Bisphosphonate drugs to treat osteoporosis are commonly used to reverse bone loss that comes with estrogen declines in post menopausal women.

Osteoporosis Drugs Inflame the Esophagus, but do they Cause Cancer?

According to information from the study authors, Esophagitis [inflammation of the esophagus] is a known adverse effect of bisphosphonate use, and recent reports suggest a link between bisphosphonate use and esophageal cancer, but this has not been robustly investigated. Large studies with appropriate comparison groups, adequate follow-up, robust characterization of bisphosphonate exposure, and information on relevant confounders are required to determine whether bisphosphonates increase esophageal cancer risk."

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No Link Found Between Esophageal Cancer and Osteoporosis Drugs

After analyzing data from 41,826 members in a control group and among individuals taking bisphosphonates, researchers say …”we found no evidence for a substantially increased risk of esophageal (or gastric) cancer in persons using oral bisphosphonates. These drugs should not be withheld, on the basis of possible esophageal cancer risk, from patients with a genuine clinical indication for their use.”

Eighty one percent of the patients analyzed were women over age 70. After 4.5 years for those taking bisphosphonates and 4.4 years for the control group there was no difference in rates of esophageal or gastric cancer between the two groups.

Some commonly used drugs to prevent and treat osteoporosis include Fosamax, Boniva, Evista, Reclast and Actonel. Past studies have linked the drugs, known as bisphosphonates to esophageal cancer. The large analysis conducted in the UK that included 80,000 patients found no risk for esophageal or gastric cancer from taking drugs for osteoporosis that can reduce the risk of fracture, hospitalization and disability.

JAMA. 2010;304[6]:657-663