Association between proton pump inhibitor use and gastric cancer: a population-based cohort study using two different types of nationwide databases in Korea

被引：81

作者：

Seo, Seung In ^{[1
,2
]}

Park, Chan Hyuk ^{[3
]}

You, Seng Chan ^{[4
]}

Kim, Jae Young ^{[5
]}

Lee, Kyung Joo ^{[5
]}

Kim, Jinseob ^{[6
]}

Kim, Yerim ^{[7
]}

Yoo, Jong Jin ^{[1
]}

Seo, Won-Woo ^{[1
]}

Lee, Hyung Seok ^{[8
]}

Shin, Woon Geon ^{[1
,2
]}

机构：

[1] Hallym Univ, Kangdong Sacred Heart Hosp, Dept Internal Med, Coll Med, Seoul, South Korea

[2] Hallym Univ, Inst Liver & Digest Dis, Chunchon, South Korea

[3] Hanyang Univ, Coll Med, Dept Internal Med, Guri Hosp, Guri, South Korea

[4] Yonsei Univ, Dept Prevent Med, Coll Med, Seoul, South Korea

[5] Hallym Univ, Univ Ind Fdn, Chunchon, South Korea

[6] Seoul Natl Univ, Sch Publ Hlth, Dept Epidemiol, Seoul, South Korea

[7] Hallym Univ, Kangdong Sacred Heart Hosp, Dept Neurol, Coll Med, Seoul, South Korea

[8] Hallym Univ, Coll Med, Dept Internal Med, Sacred Heart Hosp, Anyang, South Korea

来源：

GUT | 2021年 / 70卷 / 11期

关键词：

proton pump inhibition; gastric cancer; helicobacter pylori; HELICOBACTER-PYLORI; RISK; ERADICATION; THERAPY; BIAS;

D O I：

10.1136/gutjnl-2020-323845

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objective The association between proton pump inhibitor (PPI) use and gastric cancer related to Helicobacter pylori eradication has not been fully investigated in geographical regions with high risk of gastric cancer. We aimed to evaluate the association between PPIs and gastric cancer in Korea. Design This study analysed the original and common data model versions of the Korean National Health Insurance Service database from 2002 to 2013. We compared the incidence rates of gastric cancer after 1-year drug exposure, between new users of PPIs and other drugs excluding PPIs, by Cox proportional hazards model. We also analysed the incidence of gastric cancer among PPI users after H. pylori eradication. Results The analysis included 11 741 patients in matched PPI and non-PPI cohorts after large-scale propensity score matching. During a median follow-up of 4.3 years, PPI use was associated with a 2.37-fold increased incidence of gastric cancer (PPI >= 30 days vs non-PPI; 118/51 813 person-years vs 40/49 729 person-years; HR 2.37, 95% CI 1.56 to 3.68, p=0.001). The incidence rates of gastric cancer showed an increasing trend parallel to the duration of PPI use. In H. pylori-eradicated subjects, the incidence of gastric cancer was significantly associated with PPI use over 180 days compared with the non-PPI group (PPI >= 180 days vs non-PPI; 30/12 470 person-years vs 9/7814 person-years; HR 2.22, 95% CI 1.05 to 4.67, p=0.036). Conclusion PPI use was associated with gastric cancer, regardless of H. pylori eradication status. Long-term PPIs should be used with caution in high-risk regions for gastric cancer.

引用

页码：2066 / 2075

页数：10

共 40 条

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