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©2012 Baishideng Publishing Group Co.
World J Gastroenterol. Oct 28, 2012; 18(40): 5779-5788
Published online Oct 28, 2012. doi: 10.3748/wjg.v18.i40.5779
Published online Oct 28, 2012. doi: 10.3748/wjg.v18.i40.5779
Table 1 Search strategy
Search strategy for MEDLINE | Search strategy for EMBASE | Search strategy for Cochrane reviews of the Cochrane Library |
1. Diphosphonates [MH] OR diphosphonates [ALL] OR diphosphonate [ALL] | 1. Bisphosphonates/de | 1. Bisphosphonates [ALL] |
2. Bisphosphonates [ALL] | 2. Diphosphonate/de | 2. Diphosphonate [ALL] |
3. Alendronate [MH] OR alendronate [ALL] | 3. Alendronate/de | 3. Alendronate [ALL] |
4. Clodronic acid [MH] OR clodronic acid [ALL] OR clodronate [ALL] | 4. Clodronate/de | 4. Clodronate [ALL] |
5. Etidronic acid [MH] OR etidronic acid [ALL] OR etidronate [ALL] | 5. Etidronate/de | 5. Etidronate [ALL] |
6. Ibandronic acid [NM] OR ibandronic acid [ALL] OR ibandronate [ALL] | 6. Ibandronate/de | 6. Ibandronate [ALL] |
7. Minodronate [ALL] OR YM 529 [NM] OR YM 529 [ALL] | 7. Minodronate/de | 7. Minodronate [ALL] |
8. Neridronate [ALL] OR 6-amino-1-hydroxyhexane-1,1-diphosphonate [NM] OR 6-amino-1-hydroxyhexane-1,1-diphosphonate [ALL] | 8. Neridronate/de | 8. Neridronate [ALL] |
9. Olpadronic acid [NM] OR olpadronic acid [ALL] OR olpadronate [ALL] | 9. Olpadronate/de | 9. Olpadronate [ALL] |
10. Pamidronate [NM] OR pamidronate [ALL] | 10. Pamidronate/de | 10. Pamidronate [ALL] |
11. Risedronic acid [NM] OR risedronic acid [ALL] OR risedronate [ALL] | 11. Risedronate/de | 11. Risedronate [ALL] |
12. Tiludronic acid [NM] OR tiludronic acid [ALL] OR tiludronate [ALL] | 12. Tiludronate/de | 12. Tiludronate [ALL] |
13. Zoledronic acid [NM] OR zoledronic acid [ALL] OR zoledronate [ALL] | 13. Zoledronate/de | 13. Zoledronate [ALL] |
14. 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 | 14. 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 | 14. 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 |
15. Observational studies [ALL] | 15. Observational studies/de | |
16. CohORt studies [ALL] | 16. CohORt studies/de | [ALL] - in all text |
17. Case control studies [ALL] OR case-control studies [ALL] | 17. Case control studies/de OR case-control studies/de | |
18. Case referent studies [ALL] OR case-referent studies [ALL] | 18. Case referent studies OR case-referent studies | |
19. 15 OR 16 OR 17 OR 18 | 19. 15 OR 16 OR 17 OR 18 | |
20. 14 OR 19 | 20. 14 OR 19 | |
21. Humans [MH] | 21. [Humans]/lim | |
22. 20 AND 21 | 22. [Embase]/lim OR [embase classic]/lim | |
23. 20 AND 21 AND 22 | ||
Date of search: April 29, 2011 (1973 April 2011); Result: 1709 articles found | Date of search: April 29, 2011 (1977 April 2011);Result: 2129 articles found | Limitation: cochrane database of systematic reviews;Date of search: April 29, 2011 (1971 April 2011); Result: 47 articles found |
Table 2 Characteristics of cohort studies (n = 3) included in meta-analysis regarding use of bisphosphonates and risk of cancer
Ref. | Country | Cohort formation (population) | Study period | Mean F/U duration, yr (range) | Age, yr (mean±SD) | Sex ratio (reference group) | Type of cancer | Type of drug (reference group) | Risk estimate | Adjustment | No. of cancer development/ no. of study population | No. of total cohort | |
Bisphosphonate user | Reference group | ||||||||||||
Abrahamsen et al[10] | Denmark | Patients with fracture who had prescription for oral bisphosphonate (national registers) | E:1995-2005; F/U: -2005 | 2.8 (NA) | 74.3 ± 8.8 | M: 11; F: 89 | Esophageal cancer, gastric cancer | Any bisphosphonate use (no bisphosphonate use) | Esophageal or gastric cancer 0.78 (0.49-1.26); esophageal cancer 0.35 (0.14-0.85); gastric cancer 1.23 (0.68-2.22) | Age, sex, fracture type, Charlson index, number of concomitant medication, time to event | NA/13 678 | NA/27 356 | 41 034 |
Solomon et al[11] | United States | Patients who had prescription for oral bisphosphonate (health care utilization records of medicare beneficiaries) | NA | NA (NA) | NA | NA | Esophageal cancer | Any bisphosphonate use (other osteoporosis medications use) | Esophageal cancer 0.55 (0.06-4.72) | NA | Incidence rate 26.7/100 000 | Incidence rate 48.4/100 000 | NA |
Cardwell et al[7] | United Kingdom | Patients receiving prescription for oral bisphosphonate (GPRD) | E:1996-2006; F/U: -2008 | 4.5 (0.5-12.9) | 70.0 ± 11.4 | M: 19; F: 81 | Esophageal cancer, gastric cancer | Any bisphosphonate use (regardless of bisphosphonate use) | Gastric cancer 0.78 (0.50-1.23); esophageal cancer 1.07 (0.77-1.49) | Age, sex, general practice, BMI, cigarette smoking, alcohol intake, hormone therapy, NSAID use, Barrett's esophagus, GERD, H2 receptor antagonist use, proton pump inhibitor use | Esophageal or gastric cancer 116/41 826 (gastric cancer 37/41 826; esophageal cancer 79/41 826) | Esophageal or gastric cancer 115/41 826 (gastric cancer43/41 826; esophageal cancer 72/41 826) | 83 652 |
Table 3 Case-control studies (n = 3) included in meta-analysis regarding use of bisphosphonates and risk of cancer
Ref. | Country (study type) | Case selection method | Control sampling method | Medication data collection method (period) | Age, yr (mean±SD) | Sex ratio of cases (reference group) | Site of cancer | Type of drug (reference group) | Odd’s ratio (95% CI) | Adjustment | No. of cases/no. of controls | |
Exposed | Unexposed | |||||||||||
Green et al[8] | United Kingdom (nested case-control) | Review of computerized information (within participants of GPRD between 1995 -2005) | Matched on age (within 2 yr), sex, observation period in the database and general practice attended) | Review of computerized medical records (from 1995 until cancer diagnosis) | 72 ± 11 | M: 57; F: 43 | Gastrointestinal cancer (esophageal, gastric, colorectal) | Any bisphosphonate use (no bisphosphonate use) | Esophageal cancer 1.30 (1.02-1.66); Gastric cancer 0.87 (0.64-1.19); colorectal cancer 0.87 (0.77-1.00) | Age, sex, observation period, general practice, BMI, cigarette smoking, alcohol intake | Esophageal cancer 90/345; gastric cancer 49/270; colorectal cancer 276/1555 | Esophageal cancer 2864/14 376; gastric cancer 1969/9737; colorectal cancer 10 365/51 467 |
Nguyen et al[12] | United States (nested case-control) | Review of computerized information (within patients with Barrett’s esophagus in the national veterans affair database between 2000-2002) | Matched on age(interval of 5 yr) and Barrett’s esophagus index date | Review of computerized medical records (from Barrett’s esophagus diagnosis until 3 mo before cancer diagnosis) | 65.0 ± 10.3 | M: 2.6; F: 97.4 | Esophageal cancer | Any bisphosphonate use, mostly alendronate (no bisphosphonate use) | 0.81 (0.18-3.72) | Age, Barrett’s esophagus index date, race, non cancer disease comorbidity index, NSAID use, PPI use | 2/13 | 114/683 |
Rennert et al[13] | Israel (conventional case-control) | Review of a computerized information (within postmenopausal women in CHS database between 2000-2006) | Matched on age, sex, residence, and ethnic group in CHS database | Review of CHS pharmacy records | 71.1 ± NA | F: 100 | Colorectal cancer | Any bisphosphonate use more than 1 yr (no bisphosphonate use) | 0.41 (0.25-0.67) | BMI, family history of colorectal cancer, vegetable consumption, sports participation, use of low-dose aspirin, statins, vitamin D, postmenopausal hormones | 53/100 | 880/833 |
Table 4 Assessment of study quality
Study | Quality assessment items | ||||
Representativeness | Ascertainment of exposure: Secure record or structured interview | Demonstration that outcome of interest | Assessment of outcome: Independent blind assessment or record linkage was not present at start of study | Study controls for age, cigarette smoking, BMI status | |
Cohort studies | |||||
Steinbuch et al[9] | - (female) | + | + | + | - (randomized controlled trials) |
Abrahamsen et al[10] | + | + | - | + | + (age) |
Solomon et al[11] | - (medicare beneficiaries) | + | - | + | - (not reported) |
Cardwell et al[7] | + | + | + | + | +++ (age, cigarette smoking, BMI) |
Case-control studies | |||||
Green et al[8] | + | + | - | + | +++ (age, cigarette smoking, BMI) |
Nguyen et al[12] | - (Barrett’s esophagus) | + | + | + | + (age) |
Rennert et al[13] | - (female) | + | + | + | ++ (age, BMI) |
- Citation: Oh YH, Yoon C, Park SM. Bisphosphonate use and gastrointestinal tract cancer risk: Meta-analysis of observational studies. World J Gastroenterol 2012; 18(40): 5779-5788
- URL: https://www.wjgnet.com/1007-9327/full/v18/i40/5779.htm
- DOI: https://dx.doi.org/10.3748/wjg.v18.i40.5779