Bisphosphonate use and the risk of endometrial cancer: a meta-analysis of observational studies

Pharmacoepidemiol Drug Saf. 2016 Oct;25(10):1107-1115. doi: 10.1002/pds.4075. Epub 2016 Aug 8.

Abstract

Background: The association of bisphosphonate use and the risk of endometrial cancer is still unclear. No meta-analysis was conducted to review the evidence concerning this topic.

Methods: Relevant studies were identified through PubMed and EMBASE and the Cochrane Library databases. The adjusted relative risk (RR) or odds ratios were determined using a fixed effects or random effects model, depending on the overall heterogeneity.

Results: Seven studies, including four cohort studies and three case-control studies, met the method criteria and were included. The random effects model showed a significant reduction in the risk association between bisphosphonate use and endometrial cancer incidence (RR 0.75, 95%CI 0.60-0.94, p = 0.064, I2 = 49.6%). A significantly protective effect was observed with the use of bisphosphonate for more than 1 year, and we found a statistically significant risk reduction with the use of bisphosphonate for more than 1 to 3 years (RR 0.58, 95%CI 0.47-0.72) and for more than 3 years (RR 0.44, 95%CI 0.28-0.70). However, with the use of bisphosphonate for less than 1 year (RR 0.92, 95%CI 0.64-1.34), we found no protective effect against endometrial cancer.

Conclusions: We found that the use of bisphosphonate was significantly associated with a 25% risk reduction in the incidence of endometrial cancer in the overall analysis. Furthermore, the use of bisphosphonate for more than 1 year but not less than 1 year may have a more beneficial effect on endometrial cancer risk. Copyright © 2016 John Wiley & Sons, Ltd.

Keywords: bisphosphonate; cancer risk; endometrial cancer; meta-analysis; pharmacoepidemiology.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Bone Density Conservation Agents / administration & dosage*
  • Diphosphonates / administration & dosage*
  • Endometrial Neoplasms / epidemiology*
  • Endometrial Neoplasms / prevention & control
  • Female
  • Humans
  • Incidence
  • Protective Factors
  • Risk
  • Time Factors

Substances

  • Bone Density Conservation Agents
  • Diphosphonates