Use of proton pump inhibitors and histamine-2 receptor antagonists and risk of gastric cancer in two population-based studies

Peipei Liu*, Úna C. McMenamin, Brian T. Johnston, Peter Murchie, Lisa Iversen, Amanda Lee, Pauline A. J. Vissers, Chris R. Cardwell

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background
Studies have shown increased gastric cancer risk in users of proton pump inhibitors (PPI) and histamine-2 receptor antagonists, questioning the safety of gastric acid suppression. Therefore, we conducted a case–control study within the Scottish Primary Care Clinical Informatics Unit (PCCIU) database and a cohort study in the UK Biobank.

Methods
In PCCIU, five controls were matched to cases diagnosed in 1999–2011, and medications were determined from GP records. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression. In the UK Biobank, medications were self-reported at cohort entry 2006–2010, and gastric cancer ascertained from cancer registries until 2014. Hazard ratios (HR) were calculated using Cox regression.

Results
PCCIU contained 1119 cases and 5394 controls. UK Biobank contained 250 cases in 471,779 participants. PPI users had a higher gastric cancer risk in PCCIU and UK Biobank when applying a 1-year lag (adjusted OR = 1.49, 95% CI 1.24, 1.80; adjusted HR = 1.28, 95% CI 0.86, 1.90, respectively), but these associations were attenuated when using a 2-year lag (adjusted OR = 1.13, 95% CI 0.91, 1.40; adjusted HR = 1.15, 95% CI 0.73, 1.82, respectively).

Conclusions
Overall, we observed little consistent evidence of an increased risk of gastric cancer with PPI use.
Original languageEnglish
Pages (from-to)307-315
Number of pages9
JournalBritish Journal of Cancer
Volume123
Early online date5 May 2020
DOIs
Publication statusPublished - 21 Jul 2020

Keywords

  • ACID-SUPPRESSIVE DRUGS
  • LAG-TIME
  • ASSOCIATION
  • ESOPHAGEAL

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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