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Bisphosphonates are the principal drugs prescribed for the prevention of osteoporotic fractures. They are bone specific but poorly absorbed. In oral formulations, almost 99% of the administered dose remains within the intestinal tract and reaches the small and large bowel. Although the nitrogen-containing bisphosphonates can irritate the distal esophageal/gastric mucosa, they improve drug-induced colitis in animal models and exhibit antitumor properties on intestinal cells in vitro. Several recent epidemiological studies provide evidence of a reduced risk of colorectal cancer in osteoporotic patients treated with oral bisphosphonates, notably alendronate. In this review, we will explore the possible mechanisms of action underlying these effects and raise the question of whether these agents might be used in the chemoprophylaxis against colorectal cancer.

Original publication




Journal article


Annals of the New York Academy of Sciences

Publication Date





E19 - E25


Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Institute of Musculoskeletal Sciences, The Botnar Research Centre, Oxford University, Oxford, United Kingdom.


Intestines, Animals, Humans, Colorectal Neoplasms, Diphosphonates, Chemoprevention, Bone Density Conservation Agents