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01-01-2020 | Bisphosphonate | CANCER

Risk of colorectal cancer in users of bisphosphonates: analysis of population-based electronic health records

Authors: Gemma Ibáñez-Sanz, Elisabet Guinó, Caridad Pontes, Rosa Morros, Luisa C. de la Peña-Negro, Mª Ángeles Quijada-Manuitt, Victor Moreno

Published in: European Journal of Epidemiology | Issue 1/2020

Abstract

The use of bisphosphonates has been associated with a decrease in the risk of colorectal cancer (CRC) in observational studies, but with controversial results and difficult to interpret because of routine concomitant use of calcium and vitamin D. We aimed to assess the association between CRC risk and outpatient exposure to antiosteoporotic drugs using a large cohort with prescription data in Catalonia. A case–control study was performed using the Information System for Development of Primary Care Research (SIDIAP) which is a primary care medical record database that has linked data on reimbursed medication. The study included 25,836 cases with an incident diagnosis of CRC between 2010 and 2015 and 129,117 matched controls by age (± 5 years), sex and healthcare region. A multivariable model was built adjusting for known risk factors and comorbidities that were significantly associated to CRC in the dataset, and a propensity score for bisphosphonates. Tests for interaction for multiple drug use and stratified analysis for tumour location were prospectively planned. Overall 18,230 individuals (11.5%) were users of bisphosphonates. A significant but modest protective effect on CRC was observed for bisphosphonates (OR 0.95, 95% CI 0.91–0.99), that was no longer significant when adjusted for calcium and vitamin D (OR 0.98, 95% CI 0.93–1.03). Bisphosphonates, however, showed a dose–response effect with duration of use even when adjusted for calcium and vitamin D (OR for use > 40 months: 0.90, 95% CI 0.81–1.00, P value for trend: 0.018). The use of bisphosphonates was associated with a modest decrease in the risk of CRC, but this effect was essentially explained by concomitant use of calcium or vitamin D. The observed protective effect was stronger for long durations of use, which deserves further study.

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Title: Risk of colorectal cancer in users of bisphosphonates: analysis of population-based electronic health records
Authors: Gemma Ibáñez-Sanz
Elisabet Guinó
Caridad Pontes
Rosa Morros
Luisa C. de la Peña-Negro
Mª Ángeles Quijada-Manuitt
Victor Moreno
Publication date: 01-01-2020
Publisher: Springer Netherlands
Keywords: Bisphosphonate
Colorectal Cancer
Colorectal Cancer
Published in: European Journal of Epidemiology / Issue 1/2020
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI: https://doi.org/10.1007/s10654-019-00584-5

Keynote webinar | Spotlight on medication adherence

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Risk of colorectal cancer in users of bisphosphonates: analysis of population-based electronic health records

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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