Abstract:
OBJECTIVE:To examine the hypothesis that risk of oesophageal, but not of gastric or colorectal, cancer is increased in users of oral bisphosphonates. DESIGN:Nested case-control analysis within a primary care cohort of about 6 million people in the UK, with prospectively recorded information on prescribing of bisphosphonates. SETTING:UK General Practice Research Database cohort. PARTICIPANTS:Men and women aged 40 years or over-2954 with oesophageal cancer, 2018 with gastric cancer, and 10 641 with colorectal cancer, diagnosed in 1995-2005; five controls per case matched for age, sex, general practice, and observation time. MAIN OUTCOME MEASURES:Relative risks for incident invasive cancers of the oesophagus, stomach, and colorectum, adjusted for smoking, alcohol, and body mass index. RESULTS:The incidence of oesophageal cancer was increased in people with one or more previous prescriptions for oral bisphosphonates compared with those with no such prescriptions (relative risk 1.30, 95% confidence interval 1.02 to1.66; P=0.02). Risk of oesophageal cancer was significantly higher for 10 or more prescriptions (1.93, 1.37 to 2.70) than for one to nine prescriptions (0.93, 0.66 to 1.31) (P for heterogeneity=0.002), and for use for over 3 years (on average, about 5 years: relative risk v no prescription, 2.24, 1.47 to 3.43). Risk of oesophageal cancer did not differ significantly by bisphosphonate type, and risk in those with 10 or more bisphosphonate prescriptions did not vary by age, sex, smoking, alcohol intake, or body mass index; by diagnosis of osteoporosis, fracture, or upper gastrointestinal disease; or by prescription of acid suppressants, non-steroidal anti-inflammatory drugs, or corticosteroids. Cancers of the stomach and colorectum were not associated with prescription of bisphosphonate: relative risks for one or more versus no prescriptions were 0.87 (0.64 to 1.19) and 0.87 (0.77 to 1.00). The specificity of the association for oesophageal cancer argues against methodological problems in the selection of cases and controls or in the analysis. CONCLUSIONS:The risk of oesophageal cancer increased with 10 or more prescriptions for oral bisphosphonates and with prescriptions over about a five year period. In Europe and North America, the incidence of oesophageal cancer at age 60-79 is typically 1 per 1000 population over five years, and this is estimated to increase to about 2 per 1000 with five years' use of oral bisphosphonates.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Green J,Czanner G,Reeves G,Watson J,Wise L,Beral Vdoi
10.1136/bmj.c4444subject
Has Abstractpub_date
2010-09-01 00:00:00pages
c4444eissn
0959-8138issn
1756-1833journal_volume
341pub_type
杂志文章,多中心研究abstract:OBJECTIVES:To summarise evidence on the association between white rice consumption and risk of type 2 diabetes and to quantify the potential dose-response relation. DESIGN:Meta-analysis of prospective cohort studies. DATA SOURCES:Searches of Medline and Embase databases for articles published up to January 2012 using...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e1454
更新日期:2012-03-15 00:00:00
abstract::Several viral infections have been reported to result in more severe disease in pregnant than non-pregnant women, but the relative risks have not been well characterised. This has now been done for Lassa fever in a prospective study of 68 pregnant and 79 non-pregnant women who were admitted to hospital in Sierra Leone...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6648.584
更新日期:1988-09-03 00:00:00
abstract::The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and ju...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6948.184
更新日期:1994-07-16 00:00:00
abstract:OBJECTIVE:To investigate the risk factors for HIV infection in patients attending clinics for sexually transmitted diseases in India. DESIGN:Descriptive study of HIV serology, risk behaviour, and findings on physical examination. SUBJECTS:2800 patients presenting to outpatient clinics between 13 May 1993 and 15 July ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7000.283
更新日期:1995-07-29 00:00:00
abstract:OBJECTIVE:To assess whether customised mobile phone reminders would improve adherence to therapy and thus decrease virological failure among HIV infected patients starting antiretroviral treatment (ART). DESIGN:Randomised controlled trial among HIV infected patients initiating antiretroviral treatment. SETTING:Three ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.g5978
更新日期:2014-10-24 00:00:00
abstract::In a one year prospective study within the Trent Regional Health Authority the demand for neonatal intensive care was estimated to be 1.1 cots per 1000 births. Intensive care level 1 (as defined by the British Paediatric Association and British Association for Perinatal Paediatrics) was determined by two separate tech...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6711.1305
更新日期:1989-11-25 00:00:00
abstract::A sample of 106 senior house officers who had graduated from Nottingham University in 1987 was surveyed about their experience of and need for careers guidance, performance appraisal, and stress counselling. Of the 80 who replied, a quarter had received no careers guidance and a quarter no feedback about their work pe...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6722.445
更新日期:1990-02-17 00:00:00
abstract:OBJECTIVES:To examine a possible effect on labour of training the muscles of the pelvic floor during pregnancy. DESIGN:Randomised controlled trial. SETTING:Trondheim University Hospital and three outpatient physiotherapy clinics in a primary care setting. PARTICIPANTS:301 healthy nulliparous women randomly allocated...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38163.724306.3A
更新日期:2004-08-14 00:00:00
abstract:OBJECTIVE:To determine the association between exposure to radiotherapy for the treatment of prostate cancer and subsequent second malignancies (second primary cancers). DESIGN:Systematic review and meta-analysis of observational studies. DATA SOURCES:Medline and Embase up to 6 April 2015 with no restrictions on year...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.i851
更新日期:2016-03-02 00:00:00
abstract:OBJECTIVE:To compare ultrasonography with intravenous urography in the investigation of adults with haematuria. DESIGN:Prospective study entailing the examination of all patients with both investigations concurrently. The investigations were performed independently on routine lists by different duty radiologists. Each...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.301.6760.1074
更新日期:1990-11-10 00:00:00
abstract:OBJECTIVE:To determine the effect of four monthly vitamin D supplementation on the rate of fractures in men and women aged 65 years and over living in the community. DESIGN:Randomised double blind controlled trial of 100 000 IU oral vitamin D3 (cholecalciferol) supplementation or matching placebo every four months ove...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.326.7387.469
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that radiography of the lumbar spine in patients with low back pain is not associated with improved clinical outcomes or satisfaction with care. DESIGN:Randomised unblinded controlled trial. SETTING:73 general practices in Nottingham, north Nottinghamshire, southern Derbyshire, north ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.322.7283.400
更新日期:2001-02-17 00:00:00
abstract:OBJECTIVES:To investigate the association between environmental tobacco smoke, plasma cotinine concentration, and respiratory cancer or death. DESIGN:Nested case-control study within the European prospective investigation into cancer and nutrition (EPIC). PARTICIPANTS:303,020 people from the EPIC cohort (total 500,00...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38327.648472.82
更新日期:2005-02-05 00:00:00
abstract:OBJECTIVE:To use the rs1229984 variant in the alcohol dehydrogenase 1B gene (ADH1B) as an instrument to investigate the causal role of alcohol in cardiovascular disease. DESIGN:Mendelian randomisation meta-analysis of 56 epidemiological studies. PARTICIPANTS:261 991 individuals of European descent, including 20 259 c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.g4164
更新日期:2014-07-10 00:00:00
abstract:OBJECTIVE:To review the evidence for ethnic differences in susceptibility to adverse drug reactions (ADRs) to cardiovascular drugs. DESIGN:Systematic review and meta-analysis. DATA SOURCES:We searched Medline and Embase to March 2005. Reference lists of identified articles were hand searched for further relevant arti...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.38803.528113.55
更新日期:2006-05-20 00:00:00
abstract:OBJECTIVE:To investigate the effect of watching different types of video on energy expenditure. DESIGN:Randomised study assessing a "pleasant," an "amusing," an "exciting," and no video film clips. SUBJECTS:12 volunteers who did not know the purpose of the study. MAIN OUTCOME MEASURES:Changes in energy expenditure, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.311.7021.1664
更新日期:1995-12-23 00:00:00
abstract:OBJECTIVES:To determine whether measurement of total cholesterol concentration is sufficient to identify most patients at lipoprotein mediated risk of coronary heart disease without measurement of triglyceride and high density lipoprotein (HDL) cholesterol concentrations. DESIGN:Cross sectional screening programme. S...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6752.584
更新日期:1990-09-22 00:00:00
abstract:OBJECTIVE:To appraise a new method of prenatal screening for Down's syndrome based on maternal serum concentrations of alpha fetoprotein, unconjugated oestriol, and human chorionic gonadotrophin combined with maternal age--the "triple test." DESIGN:Examination of the cost effectiveness of the triple test relative to s...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6785.1133
更新日期:1991-05-11 00:00:00
abstract:OBJECTIVES:To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. DESIGN:Retro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f866
更新日期:2013-02-13 00:00:00
abstract:OBJECTIVES:To examine the incidence of suicides due to co-proxamol compared with tricyclic antidepressants and paracetamol, and to compare fatality rates for self poisonings with these drugs. DESIGN:Analysis of routinely collected national and local data on suicides and self poisonings. SETTING:Records of suicides in...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.326.7397.1006
更新日期:2003-05-10 00:00:00
abstract:OBJECTIVES:To calculate socioeconomic and health status measures for the primary care groups in London and to examine the association between these measures and hospital admission rates. DESIGN:Cross sectional study. SETTING:66 primary care groups in London, total list size 8.0 million people. MAIN OUTCOME MEASURES:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7268.1057
更新日期:2000-10-28 00:00:00
abstract:OBJECTIVES:To compare the efficacy and tolerability of butterbur (Petasites hybridus) with cetirizine in patients with seasonal allergic rhinitis (hay fever). DESIGN:Randomised, double blind, parallel group comparison. SETTING:Four outpatient general medicine and allergy clinics in Switzerland and Germany. PARTICIPA...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7330.144
更新日期:2002-01-19 00:00:00
abstract:OBJECTIVE:To show the influence of variations in case mix on clinical outcome indicators for patients admitted to hospital with acute stroke. DESIGN:"Before and after" cohort study, with prospective, consecutive identification of patients and prospective follow up; multiple logistic regression analyses to correct for ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7045.1503
更新日期:1996-06-15 00:00:00
abstract::Since the World Health Organization (WHO) set a goal in 1988 of eradicating polio worldwide by 2000, the incidence of the disease has declined by 90% around the world, with national immunization days conducted in more than 120 countries. More than 450 million children were immunized in 1998 alone. Now, with only abo...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.318.7186.756
更新日期:1999-03-20 00:00:00
abstract:OBJECTIVE:To compare the effect on prevalence of diarrhoea and mortality of household based treatment of drinking water with flocculant-disinfectant, sodium hypochlorite, and standard practices in areas with turbid water source in Africa. DESIGN:Cluster randomised controlled trial over 20 weeks. SETTING:Family compou...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38512.618681.E0
更新日期:2005-09-03 00:00:00
abstract:OBJECTIVE:To assess whether an assertive outreach intervention after suicide attempt could reduce the frequency of subsequent suicidal acts, compared with standard treatment. DESIGN:Randomised, parallel group, superiority trial with blinded outcome assessment. SETTING:Outpatient intervention at one location at Copenh...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.e4972
更新日期:2012-08-22 00:00:00
abstract:OBJECTIVE:To evaluate the impact of the US Air Force suicide prevention programme on risk of suicide and other outcomes that share underlying risk factors. DESIGN:Cohort study with quasi-experimental design and analysis of cohorts before (1990-6) and after (1997-2002) the intervention. PARTICIPANTS:5,260,292 US Air F...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.327.7428.1376
更新日期:2003-12-13 00:00:00
abstract:OBJECTIVE:To test the hypothesis of an association between neonatal intramuscular vitamin K and childhood leukaemia and other cancers. DESIGN:Population based case-control study with data abstracted from hospital records. SETTING:Scotland. SUBJECTS:Children aged 0-14 years resident in Scotland from 1991-4 and diagno...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7126.173
更新日期:1998-01-17 00:00:00
abstract:OBJECTIVE:To determine how changes in the number of admissions from waiting lists and changes in the number of additions to the lists are related to list size and waiting times, in the context of local waiting list initiatives. DESIGN:Review of national and Körner statistics. SETTING:England (1987-94) and districts o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7008.783
更新日期:1995-09-23 00:00:00
abstract:OBJECTIVE:To determine the clinical and cost effectiveness of booklet based vestibular rehabilitation with and without telephone support for chronic dizziness, compared with routine care. DESIGN:Single blind, parallel group, pragmatic, randomised controlled trial. SETTING:35 general practices across southern England ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.e2237
更新日期:2012-06-06 00:00:00