Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea.
Pyeongchang Health Center and County Hospital, Pyeongchang, South Korea.
Osteoporos Int. 2020 Apr;31(4):775-782. doi: 10.1007/s00198-020-05327-x. Epub 2020 Feb 7.
Few studies have explored the association of oral bisphosphonate exposure and gastrointestinal cancer within Asian populations. In this study, we investigated 45,397 Korean women from the nationwide population-based cohort from 2002 to 2013. Oral bisphosphonate exposure did not appear to be associated with elevated or reduced risk for gastrointestinal cancer.
While several studies suggested increased risk in upper gastrointestinal (GI) cancer or reduced risk in colorectal cancer upon bisphosphonate exposure, the association is less explored within Asian populations. We investigated the effect of oral bisphosphonate exposure on the risk of GI cancers within a nationwide population-based cohort.
This study used two separate cohorts. The first cohort included 45,397 women aged 60 years or older from the National Health Insurance Service-Health Screening Cohort during 2002-2013. Participants were classified into bisphosphonate users and non-users based on drug exposure during 2002-2007, and followed-up from the index date of January 1, 2008. The second cohort included 25,665 newly diagnosed osteoporosis patients who started taking oral bisphosphonate during 2003-2008. After 4 years of drug exposure period, patients were separated into quartiles based on cumulative oral bisphosphonate exposure. Participants were followed-up until December 31, 2013 for GI cancer, stomach cancer, and colorectal cancer. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) for the cancer risks.
Compared to bisphosphonate non-users, no significant risk difference was observed among bisphosphonate users on GI (HR 1.06; 95% CI 0.87-1.28), stomach (HR 1.11; 95% CI 0.85-1.47) and colorectal cancers (HR 1.04; 95% CI 0.79-1.37). Among bisphosphonate users, increasing doses of bisphosphonate exposure was not associated with elevated or reduced risk for GI cancer (p for trend 0.573).
Oral bisphosphonate use did not appear to be associated with elevated or reduced risk for GI cancers.
很少有研究探讨亚洲人群中口服双膦酸盐暴露与胃肠道癌症之间的关联。本研究调查了 2002 年至 2013 年间来自全国基于人群的队列的 45397 名韩国女性。口服双膦酸盐暴露似乎不会增加或降低胃肠道癌症的风险。
虽然有几项研究表明双膦酸盐暴露会增加上胃肠道 (GI) 癌症的风险或降低结直肠癌的风险，但在亚洲人群中，这种关联的研究较少。我们调查了口服双膦酸盐暴露对全国基于人群的队列中胃肠道癌症风险的影响。
本研究使用了两个独立的队列。第一个队列包括 2002 年至 2013 年间参加国家健康保险服务-健康筛查队列的 45397 名年龄在 60 岁或以上的女性。根据 2002 年至 2007 年的药物暴露情况，将参与者分为双膦酸盐使用者和非使用者，并从 2008 年 1 月 1 日开始随访。第二个队列包括 2003 年至 2008 年期间开始服用口服双膦酸盐的 25665 名新诊断骨质疏松症患者。在 4 年的药物暴露期后，根据累积口服双膦酸盐暴露量将患者分为四组。随访至 2013 年 12 月 31 日，以确定胃肠道癌症、胃癌和结直肠癌的发生情况。使用 Cox 比例风险回归模型评估癌症风险的风险比 (HR) 和 95%置信区间 (CI)。
与非双膦酸盐使用者相比，双膦酸盐使用者的胃肠道癌症 (HR 1.06；95%CI 0.87-1.28)、胃癌 (HR 1.11；95%CI 0.85-1.47) 和结直肠癌 (HR 1.04；95%CI 0.79-1.37) 风险无显著差异。在双膦酸盐使用者中，双膦酸盐暴露剂量的增加与胃肠道癌症的风险升高或降低无关 (趋势检验 p 值为 0.573)。
口服双膦酸盐的使用似乎与胃肠道癌症的风险升高或降低无关。
