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Nested case-control study
Long-term use of oral bisphosphonates increases the risk of oesophageal but not gastric or colorectal cancer
  1. Mahyar Etminan
  1. Department of Medicine, Division of Respiratory Medicine, University of British Columbia
  1. Correspondence to Mahyar Etminan
    709-828 West 10th Ave, Vancouver, Canada V5Z 1M9; Mahyar.etminan{at}

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Oral bisphosphonates are the most prescribed class of medications used for the prevention of osteoporosis in women. In recent years, there has been great interest in the possible association between use of oral bisphosphonates and cancer. For example, a recent subgroup analysis of the Women's Health Initiative showed that oral bisphosphonates may prevent breast cancer in postmenopausal women.1 However, the possible protective effects of oral bisphosphonates in breast cancer have been overshadowed by recent reports of 23 cases of oesophageal cancer linked to oral bisphosphonates.2 This study sought to examine the possible association between oral bisphosphonate use and the risk of oesophageal, gastric and colorectal cancer by conducting a pharmacoepidemiologic study using a large clinical database.


This study is a case-control study within a cohort of six million residents of the UK. Information on cohort subjects was obtained from the UK General Practice Research Database (GPRD).

Cases were …

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  • Competing interests None.