Author(s): Andrici J, Tio M, Eslick GD
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Abstract BACKGROUND: Bisphoshonates, which are used in the treatment and prevention of osteoporosis, have recently been implicated in the development of oesophageal cancer; however, studies report conflicting data. AIM: To conduct a meta-analysis of studies reporting on the association between bisphosphonates and oesophageal cancer to quantify the relationship. METHODS: A search was conducted through Medline, PubMed, Embase and Current Contents Connect to 2 August 2012. We calculated pooled odds ratios and 95\% CIs using a random effects model for the risk of oesophageal cancer associated with exposure to bisphosphonates, as well as for the different periods of exposure. RESULTS: Seven studies, with 19 700 oesophageal cancer cases, met our inclusion criteria. We found a positive relationship between exposure to bisphosphonates and oesophageal cancer, with an odds ratio (OR) of 1.74 with a 95\% CI of 1.19-2.55. Heterogeneity was observed (I(2 ) = 85\%, P < 0.001). Publication bias was not present. An increased risk of oesophageal cancer was also found in the group exposed to bisphosphonates for a longer period of time, compared with the group who experienced a shorter period of exposure (OR 2.32; 95\% CI 1.57-3.43 vs. OR 1.35; 95\% CI 0.77-2.39). An increased risk was associated with exposure to Etidronate (OR 1.58; 95\% CI 1.12-2.24), but not to Aledronate. CONCLUSIONS: Exposure to bisphosphonates may be associated with an increased risk of oesophageal cancer. More studies are needed to confirm the relationship. © 2012 Blackwell Publishing Ltd.
This article was published in Aliment Pharmacol Ther
and referenced in Epidemiology: Open Access