Use of oral bisphosphonates did not increase the risk of esophageal or gastric cancer in a large cohort of patients followed for more than four years.
Bisphosphonate users and nonusers had similar rates of the individual cancers and of both cancers combined, according to a report in the Aug. 11 issue of the Journal of the American Medical Association.
The findings should help allay concerns about a theoretical cancer risk related to bisphosphonates' propensity to cause esophagitis in some patients, researchers Chris R. Cardwell, PhD, of Queen's University Belfast in Ireland, and coauthors noted.
Their analysis of medical records showed esophageal cancer rates of 0.48 cases per 1,000 person-years in bisphosphonate users and 0.44 cases per 1,000 person-years in nonusers.
"These drugs should not be withheld, on the basis of possible esophageal cancer risk, from patients with a genuine clinical indication for their use," they wrote in conclusion.
Widespread use of oral bisphosphonates to treat osteoporosis has shown that some patients develop serious reflux esophagitis, a known risk factor for esophageal cancer. Crystalline material resembling a bisphosphonate has been identified in patients with bisphosphonate-related esophagitis, and follow-up endoscopy showed persistent abnormalities after healing (Gastrointest Endosc. 1998;47:525-528).
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To be honest, I have never heard of the possibility that bisphosphonates could promote cancer. Aren't they routinely used as a treatment for cancer, especially for patients with breast cancer?
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