title: The effect of bisphosphonates on the risk of endometrial and ovarian malignancies.
abstract: OBJECTIVE
  The use of bisphosphonates has been associated with reduced risk and improved survival of breast and colorectal malignancies. This study was aimed at studying the effects of bisphosphonates on gynecological cancers.
  
  
  METHODS
  The Cancer in the Ovary and Uterus Study (CITOUS) is a case-control study of newly diagnosed cases of gynecological malignancies and age/clinic/ethnic-group matched population controls. The use of bisphosphonates prior to, and following, diagnosis was assessed in 424 cases of ovarian and endometrial cancers and 341 controls, all postmenopausal at recruitment, enrolled in Clalit Health Services (CHS), using pharmacy records.
  
  
  RESULTS
  The use of bisphosphonates for more than 1 year prior to diagnosis was associated with a significantly reduced risk of ovarian cancer (OR=0.49, 95% CI: 0.26-0.93) and endometrial cancer (OR=0.39, 95% CI: 0.24-0.63). The association with endometrial cancer (OR=0.48, 0.27-0.84) remained statistically significant after adjustment for a variety of putative effect modifiers (RR=0.48, 0.26-0.89). The association with ovarian cancer remained significant when adjusted to statin use (0.46, 0.23-0.90) but not for other modifiers (0.58, 0.29-1.18). A strong negative association was found in an adjusted model for the use of either bisphosphonates or statins for more than 1 year (0.40, 0.23-0.68).
  
  
  CONCLUSIONS
  The use of bisphosphonates, with or without statins, for more than 1 year before diagnosis was associated with reduced risk of endometrial and ovarian cancers.
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel. Electronic address: rennert@tx.technion.ac.il.
authors.forename: Gad
authors.initials: G
authors.lastname: Rennert
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel.
authors.forename: Hedy S
authors.initials: HS
authors.lastname: Rennert
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel.
authors.forename: Mila
authors.initials: M
authors.lastname: Pinchev
authors.affiliation: Gyneco-Oncology Unit, Department of Obstetrics and Gynecology, Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology and Clalit Health Services National Cancer Control Center, Haifa, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Lavie
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D004164:Diphosphonates / Q000627:therapeutic use*; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Bisphosphonates; Endometrial cancer; Ovarian cancer; Prevention; Risk