Department of Family Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Department of Biomedical Sciences, Seoul National University Graduate School, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Arch Osteoporos. 2019 Mar 19;14(1):41. doi: 10.1007/s11657-019-0588-z.
Bisphosphonate use was not associated with the risk of female breast, ovarian, or cervical cancer. The results according to bisphosphonate type or concurrent drug uses were not associated with the cancer risk. The protective effect of bisphosphonate use on female breast cancer was significant in the low comorbidity group.
Despite the antitumor mechanisms, the effect of bisphosphonates on the risk of cancer is still unclear. We investigated the association between oral bisphosphonate use and the development of female breast, ovarian, and cervical cancer.
We accomplished a population-based cohort study using the National Health Insurance Services (NHIS) database. A total of 204,525 participants were included in a cohort, and we identified the incident cases of each cancer from 2007 to 2013. We assessed cumulative bisphosphonate exposure from 2003 to 2006 using the defined daily dose (DDD) system. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were presented to assess the association between bisphosphonate use and cancer incidence using multivariate Cox proportional hazard regression models. Subgroup analyses were performed to assess cancer development according to risk factors and concurrent drug use.
There was a total of 1547, 266, and 370 incident cases of female breast, cervical, and ovarian cancer, respectively, during the study period of 1,367,294 person-years. Bisphosphonate exposure was not significantly associated with risk of female breast (adjusted HR (aHR), 0.78; 95% CI, 0.60-1.02), ovarian (aHR, 1.30; 95% CI, 0.82-2.07), nor cervical cancer (aHR, 0.70; 95% CI, 0.44-1.12). Further subgroup analyses also revealed no statistically significant effects of bisphosphonate use with various risk factors and concurrent drug use.
Our study showed no significant associations between bisphosphonate exposure and female breast, cervical, and ovarian cancer. In the future, large prospective studies or a meta-analysis would be needed to verify the associations.
双膦酸盐的使用与女性乳腺癌、卵巢癌或宫颈癌的风险无关。根据双膦酸盐的类型或同时使用的药物，结果与癌症风险无关。双膦酸盐的使用对女性乳腺癌的保护作用在低合并症组中是显著的。
尽管有抗肿瘤机制，但双膦酸盐对癌症风险的影响仍不清楚。我们研究了口服双膦酸盐的使用与女性乳腺癌、卵巢癌和宫颈癌的发展之间的关系。
我们使用国家健康保险服务（NHIS）数据库完成了一项基于人群的队列研究。共有 204525 名参与者被纳入队列，我们从 2007 年至 2013 年确定了每种癌症的发病病例。我们使用定义日剂量（DDD）系统评估了 2003 年至 2006 年的累积双膦酸盐暴露情况。使用多变量 Cox 比例风险回归模型，以风险比（HR）及其 95%置信区间（CI）来评估双膦酸盐的使用与癌症发病率之间的关系。进行亚组分析，以评估根据风险因素和同时使用的药物进行癌症发展的情况。
在研究期间的 1367294 人年中，共发生了 1547 例、266 例和 370 例女性乳腺癌、宫颈癌和卵巢癌的发病病例。双膦酸盐暴露与女性乳腺癌的风险无显著相关性（调整后的 HR（aHR），0.78；95%CI，0.60-1.02）、卵巢癌（aHR，1.30；95%CI，0.82-2.07）或宫颈癌（aHR，0.70；95%CI，0.44-1.12）。进一步的亚组分析也没有显示出双膦酸盐使用与各种风险因素和同时使用的药物之间有统计学意义的影响。
我们的研究表明，双膦酸盐暴露与女性乳腺癌、宫颈癌和卵巢癌之间没有显著的关联。未来需要进行大型前瞻性研究或荟萃分析来验证这些关联。
