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Research article:
Bisphosphonates and Risk of Upper Gastrointestinal Cancer — A Case Control Study Using the General Practice Research Database (GPRD)
Reference:
Ellen Wright, Peter T. Schofield, Paul Seed, Mariam Molokhia(2012) Bisphosphonates and Risk of Upper Gastrointestinal Cancer — A Case Control Study Using the General Practice Research Database (GPRD). PLoS ONE, doi: 10.1371/journal.pone.0047616
- Link to fulltext article
- Abstract
- Background Concerns have been raised as to the safety of bisphosphonates; in particular a possible link between bisphosphonate use and upper gastrointestinal (GI) cancer. Two published studies using different study populations but drawn from earlier versions of the same national UK database, reached differing conclusions: one finding no evidence for an increase in the risk of gastric or oesophageal cancer in bisphosphonate users and one finding a small but significantly increased risk of oesophageal cancer linked to duration of bisphosphonate use. Methodology/ Principal Findings Design-A case control study comparing bisphosphonate prescribing in cases of upper GI cancer from 1995 to 2007 using UK primary care electronic health records (GPRD). Main Outcome Measure-Relative Risk (approximated to Odds Ratio for rare events) for oesophageal and gastric cancer development in bisphosphonate users compared to non–users. The odds of being a case of oesophageal cancer, adjusted for smoking status, were significantly increased in women who had had one or more bisphosphonate prescriptions, odds ratio 1·54 (95% CI 1·27–1·88) compared to non-users. There was no significant effect on gastric cancer in women, odds ratio adjusted for smoking status, 1.06 (95% CI 0.83–1.37) and also no apparent risk in men for either oesophageal or gastric cancer, odds ratio adjusted for smoking status 0.78 (95%CI 0.56–1.09) and 0.87 (95% CI 0.55–1.36) respectively. Conclusions/ Significance Our results support a small but significant increased risk of oesophageal cancer in women prescribed bisphosphonates and is based on the largest number of exposed cases to date in the UK.
- Author for correspondence
- Ellen Wright
- Email for correspondence
- ellen.wright@kcl.ac.uk
Code list: res14: Upper gastrointestinal malignancy
41 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| B10..00 | Read | Malignant neoplasm of oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B100.00 | Read | Malignant neoplasm of cervical oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B101.00 | Read | Malignant neoplasm of thoracic oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B102.00 | Read | Malignant neoplasm of abdominal oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B103.00 | Read | Malignant neoplasm of upper third of oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B104.00 | Read | Malignant neoplasm of middle third of oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B105.00 | Read | Malignant neoplasm of lower third of oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B106.00 | Read | Malignant neoplasm; overlapping lesion of oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B107.00 | Read | Siewert type I adenocarcinoma | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B10y.00 | Read | Malignant neoplasm of other specified part of oesophagus | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B10z.00 | Read | Malignant neoplasm of oesophagus NOS | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B10z.11 | Read | Oesophageal cancer | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B11..00 | Read | Malignant neoplasm of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B110.00 | Read | Malignant neoplasm of cardia of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B110100 | Read | Malignant neoplasm of cardio-oesophageal junction of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B110111 | Read | Malignant neoplasm of gastro-oesophageal junction | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B110z00 | Read | Malignant neoplasm of cardia of stomach NOS | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B111.00 | Read | Malignant neoplasm of pylorus of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B111000 | Read | Malignant neoplasm of prepylorus of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B11..11 | Read | Gastric neoplasm | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B111100 | Read | Malignant neoplasm of pyloric canal of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B111z00 | Read | Malignant neoplasm of pylorus of stomach NOS | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B112.00 | Read | Malignant neoplasm of pyloric antrum of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B113.00 | Read | Malignant neoplasm of fundus of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B114.00 | Read | Malignant neoplasm of body of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B115.00 | Read | Malignant neoplasm of lesser curve of stomach unspecified | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B116.00 | Read | Malignant neoplasm of greater curve of stomach unspecified | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B117.00 | Read | Malignant neoplasm; overlapping lesion of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B118.00 | Read | Siewert type II adenocarcinoma | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B119.00 | Read | Siewert type III adenocarcinoma | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B11y.00 | Read | Malignant neoplasm of other specified site of stomach | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B11y000 | Read | Malignant neoplasm of anterior wall of stomach NEC | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B11y100 | Read | Malignant neoplasm of posterior wall of stomach NEC | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B11yz00 | Read | Malignant neoplasm of other specified site of stomach NOS | diagnostic | res14: Upper gastrointestinal malignancy | |||
| B11z.00 | Read | Malignant neoplasm of stomach NOS | diagnostic | res14: Upper gastrointestinal malignancy | |||
| BB55.00 | Read | [M]Linitisplastica | diagnostic | res14: Upper gastrointestinal malignancy | |||
| BB5C.00 | Read | [M]Gastrinoma and carcinomas | diagnostic | res14: Upper gastrointestinal malignancy | |||
| BB5C000 | Read | [M]Gastrinoma NOS | diagnostic | res14: Upper gastrointestinal malignancy | |||
| BB5C011 | Read | [M]G cell tumour NOS | diagnostic | res14: Upper gastrointestinal malignancy | |||
| BB5C100 | Read | [M]Gastrinoma; malignant | diagnostic | res14: Upper gastrointestinal malignancy | |||
| BB5Cz00 | Read | [M]Gastrinoma or carcinoma NOS | diagnostic | res14: Upper gastrointestinal malignancy |
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