title: Oral Bisphosphonate Exposure and the Risk of Upper Gastrointestinal Cancers.
abstract: The association between oral bisphosphonate use and upper gastrointestinal cancer has been controversial. Therefore, we examined the association with esophageal and gastric cancer within the Kaiser Permanente, Northern California population. A total of 1,011 cases of esophageal (squamous cell carcinoma and adenocarcinoma) and 1,923 cases of gastric adenocarcinoma (cardia, non-cardia and other) diagnosed between 1997 and 2011 from the Kaiser Permanente, Northern California cancer registry were matched to 49,886 and 93,747 controls, respectively. Oral bisphosphonate prescription fills at least one year prior to the index date were extracted. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between prospectively evaluated oral bisphosphonate use with incident esophageal and gastric cancer diagnoses with adjustment for potential confounders. After adjustment for potential confounders, no significant associations were found for esophageal squamous cell carcinoma (OR 0.88; 95% CI: 0.51, 1.52), esophageal adenocarcinoma (OR 0.68; 95% CI: 0.37, 1.24), or gastric non-cardia adenocarcinoma (OR 0.83, 95% CI: 0.59, 1.18), but we observed an adverse association with gastric cardia adenocarcinoma (OR 1.64; 95% CI: 1.07, 2.50). In conclusion, we observed no association between oral bisphosphonate use and esophageal cancer risk within a large community-based population. A significant association was detected with gastric cardia and other adenocarcinoma risk, although this needs to be replicated.
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America; Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Emily
authors.initials: E
authors.lastname: Vogtmann
authors.affiliation: Division of Research, Kaiser Permanente, Oakland, California, United States of America.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Corley
authors.affiliation: Division of Research, Kaiser Permanente, Oakland, California, United States of America.
authors.forename: Lucy M
authors.initials: LM
authors.lastname: Almers
authors.affiliation: Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
authors.forename: Chris R
authors.initials: CR
authors.lastname: Cardwell
authors.affiliation: Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
authors.forename: Liam J
authors.initials: LJ
authors.lastname: Murray
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Christian C
authors.initials: CC
authors.lastname: Abnet
mesh_terms: D000230:Adenocarcinoma / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D002140:California / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D004164:Diphosphonates / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D004947:Esophagus / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D041981:Gastrointestinal Tract / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates