TUESDAY, August 10 (Health.com) — Popular bone drugs taken by millions of older people to prevent osteoporosis do not appear to raise the risk of cancer in the esophagus, as some doctors and patients have feared.
A study of more than 80,000 people, published this week in the Journal of the American Medical Association, found no measurable difference in the rates of esophageal cancer in people who did and did not take oral bisphosphonates, a class of drugs that fight age-related bone loss.
Oral bisphosphonates—which include drugs such as Fosamax and Boniva—can upset the stomach and cause acid reflux, although it helps to take the medication as directed. Chronic acid reflux can damage the esophagus and in rare cases cause precancerous changes.
But the study suggests that esophageal cancer is not a concern for people taking oral bisphosphonates, says Nancy Lane, MD, the director of the Center for Healthy Aging at the University of California, Davis.
“Older individuals taking bisphosphonates for the treatment of osteoporosis do not need to worry about esophageal cancer, and physicians should not withhold…bisphosphonates because of esophageal cancer risk,” says Dr. Lane, who was not involved in the research.
A potential link between oral bisphosphonates and esophageal cancer was first raised last year, when a Food and Drug Administration (FDA) official disclosed that the agency had received nearly two dozen reports of esophageal cancer—including eight deaths—in people taking oral bisphosphonates, most notably Fosamax. (No cases were reported in people taking intravenous forms of the drugs.)
Researchers at the National Cancer Institute and Queen’s University Belfast, in the U.K., conducted the new study in response to these reports. They compared the rates of esophageal and stomach cancer in 83,652 people, half of whom had received at least one prescription for oral bisphosphonates in the previous decade. Just over 80% of the participants were women, and the average age was 70.
Very few participants developed esophageal or stomach cancer during the study. Eighty-nine and 92 cases of esophageal cancer were reported in the bisphosphonate and control groups, respectively, as were 49 and 57 cases of stomach cancer—a negligible difference.
Next page: Reassuring, but not the final word
