Novelty and Impact: This is the first study to investigate the impact of tetracyclines and spironolactone use on gastro-oesophageal cancer risk. Our findings should provide considerable reassurance to the many GPs and patients prescribing or taking these medications. Previous evidence around the effect of bisphosphonates on gastro-oesophageal cancer risk is mixed. Our work provides further evidence of no association, and could suggest that previous findings of positive associations might have been impaired by ascertainment bias.
Abstract (Structured)Purpose: Bisphosphonate, tetracycline and spironolactone use has been shown to increase gastrooesophageal inflammation, an accepted risk factor for cancer. We explore whether use of these medications is associated with an increased risk of gastro-oesophageal cancer.
Methods:A nested case-control study was conducted using the Primary Care Clinical Information Unit Research (PCCIUR) database from Scotland. Cases with oesophageal or gastric cancer between 1999 and 2011 were matched to up to five controls based on age, gender, year of diagnosis and general practice. Medication use was ascertained using electronic prescribing records. Conditional logistic regression was used to calculate odds ratios (ORs) for the association between medication use and cancer risk after adjustment for comorbidities and other medication use.Results: A similar proportion of gastro-oesophageal cancer cases received bisphosphonates (3.9% vs.3.5%), tetracycline (6.0% vs. 6.0%) and spironolactone (1.4% vs. 1.1%) compared with the controls.
Conclusions:There is little evidence that that the use of bisphosphonate, tetracycline or spironolactone is associated with increased risk of gastro-oesophageal cancer. Our findings should reassure GPs and patients that these widely-used medications are safe with respect to gastrooesophageal cancer risk.
Abstract (Unstructured)Bisphosphonate, tetracycline and spironolactone use has been shown to increase gastrooesophageal inflammation, an accepted risk factor for cancer. However, evidence on the effect of these medications on gastro-oesophageal cancer risk are mixed or missing entirely. Therefore, we conducted a nested case-control study using the Primary Care Clinical Information Unit Research (PCCIUR) database from Scotland. Cases with oesophageal or gastric cancer between 1999 and 2011 were matched to up to five controls based on age, gender, year of diagnosis and general practice.Medication use was ascertained using electronic prescribing records. Conditional logistic regression was used to calculate odds ratios (ORs) for the association between medication use and cancer risk after adjustment for comorbidities and other medication use.A similar proportion of gastro-oesophageal cancer cases received bisphosphonates (3.9% vs. 3.5%), tetracycline (6.0% vs. 6.0%) and spironolactone (1.4% vs. 1.1%) compared with the controls. The that that the use of bisphosphonate, tetracycline or spironolactone is associated with increased risk of gastro-oesophageal cancer. ...