Oral bisphosphonate use and colorectal cancer incidence in the Women's Health Initiative.
Oral bisphosphonate use and colorectal cancer incidence in the Women's Health Initiative.
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DOI：
10.1002/jbmr.1930
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发表时间：
2013-09
影响因子：
6.2
通讯作者：
Chlebowski, Rowan T.
中科院分区：
文献类型：
--
作者：
Passarelli, Michael N.;Newcomb, Polly A.;LaCroix, Andrea Z.;Lane, Dorothy S.;Ho, Gloria Y. F.;Chlebowski, Rowan T.
双膦酸盐被广泛用于增加绝经后骨质减少或骨质疏松妇女的骨密度。氨基二膦酸盐具有许多抗癌特性，并减少癌症患者的骨转移。包括妇女健康倡议（WHI）在内的几项研究发现，使用口服双膦酸盐与降低患乳腺癌的风险有关，但对与女性其他常见恶性肿瘤如结直肠癌（CRC）的相关性知之甚少。一些病例对照和回顾性队列研究报告了双膦酸盐使用者中CRC的风险降低。相比之下，一项前瞻性队列研究没有发现相关性。我们在156,826名年龄在50-79岁的绝经后妇女中评估了口服双膦酸盐与CRC发病率之间的关系，这些妇女参加了WHI临床试验和观察性研究。在基线时进行详细的健康访谈，并从基线和随访时经常使用的药物清单中确定双膦酸盐的使用。在中位随访12年期间，共有1，931名妇女被诊断为侵袭性CRC。阿仑膦酸盐是最常用的双膦酸盐，占总使用人年的90%以上。口服双膦酸盐与结直肠癌风险之间的相关性未达到统计学显著性（来自多变量校正模型的风险比[HR]，0.88; 95%置信区间[CI]，0.72-1.07; P=0.19）。此外，我们没有观察到使用时间较长的女性的风险降低幅度更大。未控制的混杂因素可以解释为什么以前的研究观察到了这种关联。
Bisphosphonates are widely-prescribed to increase bone density in postmenopausal women with osteopenia or osteoporosis. Amino-bisphosphonates have numerous anticancer properties and reduce bone-metastases in cancer patients. Several studies, including the Women’s Health Initiative (WHI), have found that use of oral bisphosphonates is associated with reduced risk of developing breast cancer, but less is known about associations with other common malignancies in women such as colorectal cancer (CRC). A few case-control and retrospective cohort studies have reported decreased risk of CRC among bisphosphonate users. In contrast, a prospective cohort study found no association. We evaluated the association between oral bisphosphonate use and CRC incidence in 156,826 postmenopausal women, ages 50–79, who participated in WHI clinical trials and observational study. A detailed health interview was conducted at baseline, and bisphosphonate use was ascertained from an inventory of regularly-used medications at baseline and over follow-up. A total of 1,931 women were diagnosed with incident invasive CRC during a median follow-up of 12 years. Alendronate was the most commonly used bisphosphonate, accounting for >90% of the total person-years of use. The association between oral bisphosphonate use and CRC risk did not reach statistical significance (hazard ratio [HR] from multivariable-adjusted models, 0.88; 95% confidence interval [CI], 0.72–1.07; P=0.19). Furthermore, we did not observe greater risk reductions for women with longer duration of use. Uncontrolled confounding may explain why previous studies have observed an association.
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影响因子：
5.6
作者：
Anderson, GL;Manson, J;Prentice, RL
通讯作者：
Prentice, RL
影响因子：
6.2
作者：
Singh, Harminder;Nugent, Zoann;Bernstein, Charles
通讯作者：
Bernstein, Charles
影响因子：
45.3
作者：
Rennert, Gad;Pinchev, Mila;Gruber, Stephen B.
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Gruber, Stephen B.
影响因子：
120.7
作者：
Robbins, John;Aragaki, Aaron K.;Cauley, Jane
通讯作者：
Cauley, Jane
影响因子：
5.6
作者：
Curb, JD;McTiernan, A;Daugherty, S
通讯作者：
Daugherty, S