The use of bisphosphonates and the risk of esophageal cancer have recently received increasing concern and related studies have yielded controversial results. The present meta-analysis of observational studies shows that no clear association between bisphosphonate treatment and risk of esophageal cancer was observed. Introduction: Epidemiological evidence suggests that bisphosphonate treatment can increase the risk of esophageal cancer. However, data on this issue are unstable and controversial. We conducted a meta-analysis to provide a quantitative assessment of the association between use of bisphosphonates and risk of esophageal cancer. Methods: We searched the Medline and Embase databases up to May 2012 to identify studies related to bisphosphonates and esophageal cancer. Summary effect estimates with 95 % confidence intervals (CI) were derived using a fixed or random effects model, depending on the heterogeneity of the included studies. Results: Seven epidemiologic studies that consisted of four cohort studies and three case-control studies were included in this meta-analysis. In our primary analysis, bisphosphonate treatment was not associated with risk of esophageal cancer in both cohort studies [pooled relative risk (RR) 1.23, 95 % CI 0.79-1.92] and case-control studies [pooled odds ratio (OR) 1.24, 95 % CI 0.98-1.57]. Evidence for the presence of significant heterogeneity was found in cohort studies (p = 0.009, I 2 = 74 %) but not in case-control studies (p = 0.338, I 2 = 7.8 %). In our secondary analysis, no significant increased risk of esophageal cancer was found in alendronate users (pooled RR 1.08, 95 % CI 0.67-1.75 in cohort studies; pooled OR 1.16, 95 % CI 0.82-1.63 in case-control studies). Conclusions: Based on current evidences, bisphosphonate treatment was not significantly associated with excess risk of esophageal cancer. © 2012 International Osteoporosis Foundation and National Osteoporosis Foundation.
CITATION STYLE
Sun, K., Liu, J. M., Sun, H. X., Lu, N., & Ning, G. (2013). Bisphosphonate treatment and risk of esophageal cancer: A meta-analysis of observational studies. Osteoporosis International, 24(1), 279–286. https://doi.org/10.1007/s00198-012-2158-8
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