Abstract

Summary

Few studies have explored the association of oral bisphosphonate exposure and gastrointestinal cancer within Asian populations. In this study, we investigated 45,397 Korean women from the nationwide population-based cohort from 2002 to 2013. Oral bisphosphonate exposure did not appear to be associated with elevated or reduced risk for gastrointestinal cancer.

Introduction

While several studies suggested increased risk in upper gastrointestinal (GI) cancer or reduced risk in colorectal cancer upon bisphosphonate exposure, the association is less explored within Asian populations. We investigated the effect of oral bisphosphonate exposure on the risk of GI cancers within a nationwide population-based cohort.

Methods

This study used two separate cohorts. The first cohort included 45,397 women aged 60 years or older from the National Health Insurance Service-Health Screening Cohort during 2002–2013. Participants were classified into bisphosphonate users and non-users based on drug exposure during 2002–2007, and followed-up from the index date of January 1, 2008. The second cohort included 25,665 newly diagnosed osteoporosis patients who started taking oral bisphosphonate during 2003–2008. After 4 years of drug exposure period, patients were separated into quartiles based on cumulative oral bisphosphonate exposure. Participants were followed-up until December 31, 2013 for GI cancer, stomach cancer, and colorectal cancer. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) for the cancer risks.

Results

Compared to bisphosphonate non-users, no significant risk difference was observed among bisphosphonate users on GI (HR 1.06; 95% CI 0.87–1.28), stomach (HR 1.11; 95% CI 0.85–1.47) and colorectal cancers (HR 1.04; 95% CI 0.79–1.37). Among bisphosphonate users, increasing doses of bisphosphonate exposure was not associated with elevated or reduced risk for GI cancer (p for trend 0.573).

Conclusion

Oral bisphosphonate use did not appear to be associated with elevated or reduced risk for GI cancers.

中文翻译：

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口服双膦酸盐和胃肠道癌的风险

摘要

概要

很少有研究探讨亚洲人群中口服双膦酸盐暴露与胃肠道癌症的关系。在这项研究中，我们调查了2002年至2013年来自全国人群的45,397名韩国妇女。口服双膦酸盐似乎与胃肠道癌风险增高没有关系。

介绍

尽管有几项研究表明，双膦酸盐暴露会增加上消化道（GI）癌症的风险或降低结直肠癌的风险，但在亚洲人群中这种关联的研究较少。我们调查了全国范围内以人群为基础的口服双膦酸盐暴露对胃肠道癌风险的影响。

方法

这项研究使用了两个独立的队列。第一个队列包括2002-2013年来自美国国家健康保险服务健康检查队列的45,97名年龄在60岁以上的女性。根据2002-2007年的药物暴露情况，从2008年1月1日开始对参与者进行双膦酸盐使用和非使用。第二队列包括25665名新诊断的骨质疏松症患者，他们在2003年开始服用口服双膦酸盐。 2008。在服药4年后，根据累积的口服双膦酸盐暴露量将患者分为四分位数。对参与者的胃肠道癌，胃癌和结直肠癌随访至2013年12月31日。使用Cox比例风险回归模型评估癌症风险的风险比（HRs）和95％置信区间（CIs）。

结果

与不使用双膦酸盐的人相比，双膦酸盐使用者在胃肠道（HR 1.06; 95％CI 0.87-1.28），胃癌（HR 1.11; 95％CI 0.85-1.47）和结直肠癌（HR 1.04; 95）之间没有观察到明显的风险差异。 ％CI 0.79–1.37）。在双膦酸盐使用者中，增加双膦酸盐暴露剂量与胃肠道癌风险的升高或降低无关（趋势p值为0.573）。

结论

口服双膦酸盐似乎与胃肠道癌的风险升高或降低无关。