Exposure to bisphosphonates and risk of cancer: a protocol for nested caseecontrol studies using the QResearch primary care database

Vinogradova, Yana and Coupland, Carol and Hippisley-Cox, Julia (2012) Exposure to bisphosphonates and risk of cancer: a protocol for nested caseecontrol studies using the QResearch primary care database. BMJ Open, 2 (1). e000548/1-e000548/6. ISSN 2044-6055

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Introduction: Bisphosphonates are becoming

a common treatment for osteoporosis particularly after

discovery of the association between hormone

replacement therapy and increased risk of breast

cancer. As osteoporosis develops with age, treatment

is a long-term intervention. Randomised control trials

typically have limited follow-up times, which restricts

investigation of the effects of the drugs on risk of

primary cancers. A few observational studies have

demonstrated a reduced risk of breast cancer and

possibly of endometrial cancer in bisphosphonate

users. Two epidemiological studies have studied the

effect of the drugs on oesophageal cancer but did not

reach any definite conclusions. So far, no effects on

colorectal and stomach cancer have been shown. This

study will investigate the association of

bisphosphonates with risks of the 10 most common

primary cancers.

Methods and analysis: A series of nested

caseecontrol studies will be based on the general

population using records from 660 UK general

practices within the QResearch Database. Cases will be

patients with primary cancers diagnosed between

1996 and 2011. Each case will be matched by age, sex,

practice and calendar year to five controls, who are

alive and registered with the practice at the time of

diagnosis of the case. Exposure to bisphosphonates

will be defined as at least one prescription during the

study period. For the most common cancers with

substantial numbers of observations, the effect of the

duration of the treatment and different types of

bisphosphonates will be studied. Conditional logistic

regression will be applied to produce ORs adjusted for

smoking status, socioeconomic status, ethnicity,

cancer-specific co-morbidities and use of other


Item Type: Article
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine
Identification Number: https://doi.org/10.1136/bmjopen-2011-000548
Depositing User: de Sousa, Mrs Shona
Date Deposited: 22 Apr 2014 09:30
Last Modified: 14 Sep 2016 22:28
URI: http://eprints.nottingham.ac.uk/id/eprint/2980

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