Once the red flag on the use of the drug was raised more and more investigations were carried out especially in Europe to find out whether the drug actually carried the risks it was being associated with. Among one of the major concerns of the investigators was the issue that the prolonged use of the drug led to some types of cancer.

However there were other undesirable conditions that were still associated with the drug that were still under investigations. The study involved about 155,000 patients who had been using the drug for more than 3 years constantly.

After some intensive investigations on the drug it was determined that among the group that had been indentified for investigations the ratio at risk of developing actos caused bladder cancer cancer was 1.22.The risk of developing cancer was higher among those who used the drug in the long term that those who only use the drug briefly.