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Article: Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: A population-based study

TitleLong-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: A population-based study
Authors
KeywordsGastric adenocarcinoma
Helicobacterpylori
Stomach cancer
Issue Date2018
PublisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
Citation
Gut, 2018, v. 67 n. 1, p. 28-35 How to Cite?
AbstractObjective: Proton pump inhibitors (PPIs) is associated with worsening of gastric atrophy, particularly in Helicobacter pylori (HP)-infected subjects. We determined the association between PPIs use and gastric cancer (GC) among HP-infected subjects who had received HP therapy. Designs: This study was based on a territory-wide health database of Hong Kong. We identified adults who had received an outpatient prescription of clarithromycin-based triple therapy between year 2003 and 2012. Patients who failed this regimen, and those diagnosed to have GC within 12 months after HP therapy, or gastric ulcer after therapy were excluded. Prescriptions of PPIs or histamine-2 receptor antagonists (H2RA) started within 6 months before GC were excluded to avoid protopathic bias. We evaluated GC risk with PPIs by Cox proportional hazards model with propensity score adjustment. H2RA was used as a negative control exposure. Result: Among the 63 397 eligible subjects, 153 (0.24%) developed GC during a median follow-up of 7.6 years. PPIs use was associated with an increased GC risk (HR 2.44, 95% CI 1.42 to 4.20), while H2RA was not (HR 0.72, 95% CI 0.48 to 1.07). The risk increased with duration of PPIs use (HR 5.04, 95% CI 1.23 to 20.61; 6.65, 95% CI 1.62 to 27.26 and 8.34, 95% CI 2.02 to 34.41 for ≥1 year, ≥2 years and ≥3 years, respectively). The adjusted absolute risk difference for PPIs versus non-PPIs use was 4.29 excess GC (95% CI 1.25 to 9.54) per 10 000 person-years. Conclusion: Long-term use of PPIs was still associated with an increased GC risk in subjects even after HP eradication therapy.
Persistent Identifierhttp://hdl.handle.net/10722/250013
ISSN
2019 Impact Factor: 19.819
2015 SCImago Journal Rankings: 6.474
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCheung, KSM-
dc.contributor.authorChan, EW-
dc.contributor.authorWong, YS-
dc.contributor.authorChen, L-
dc.contributor.authorWong, ICK-
dc.contributor.authorLeung, WK-
dc.date.accessioned2017-12-20T09:19:22Z-
dc.date.available2017-12-20T09:19:22Z-
dc.date.issued2018-
dc.identifier.citationGut, 2018, v. 67 n. 1, p. 28-35-
dc.identifier.issn0017-5749-
dc.identifier.urihttp://hdl.handle.net/10722/250013-
dc.description.abstractObjective: Proton pump inhibitors (PPIs) is associated with worsening of gastric atrophy, particularly in Helicobacter pylori (HP)-infected subjects. We determined the association between PPIs use and gastric cancer (GC) among HP-infected subjects who had received HP therapy. Designs: This study was based on a territory-wide health database of Hong Kong. We identified adults who had received an outpatient prescription of clarithromycin-based triple therapy between year 2003 and 2012. Patients who failed this regimen, and those diagnosed to have GC within 12 months after HP therapy, or gastric ulcer after therapy were excluded. Prescriptions of PPIs or histamine-2 receptor antagonists (H2RA) started within 6 months before GC were excluded to avoid protopathic bias. We evaluated GC risk with PPIs by Cox proportional hazards model with propensity score adjustment. H2RA was used as a negative control exposure. Result: Among the 63 397 eligible subjects, 153 (0.24%) developed GC during a median follow-up of 7.6 years. PPIs use was associated with an increased GC risk (HR 2.44, 95% CI 1.42 to 4.20), while H2RA was not (HR 0.72, 95% CI 0.48 to 1.07). The risk increased with duration of PPIs use (HR 5.04, 95% CI 1.23 to 20.61; 6.65, 95% CI 1.62 to 27.26 and 8.34, 95% CI 2.02 to 34.41 for ≥1 year, ≥2 years and ≥3 years, respectively). The adjusted absolute risk difference for PPIs versus non-PPIs use was 4.29 excess GC (95% CI 1.25 to 9.54) per 10 000 person-years. Conclusion: Long-term use of PPIs was still associated with an increased GC risk in subjects even after HP eradication therapy.-
dc.languageeng-
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/-
dc.relation.ispartofGut-
dc.rightsGut. Copyright © BMJ Publishing Group.-
dc.subjectGastric adenocarcinoma-
dc.subjectHelicobacterpylori-
dc.subjectStomach cancer-
dc.titleLong-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: A population-based study-
dc.typeArticle-
dc.identifier.emailCheung, KSM: cks634@hku.hk-
dc.identifier.emailChan, EW: ewchan@hku.hk-
dc.identifier.emailWong, YS: angelwys@hku.hk-
dc.identifier.emailChen, L: equalclj@hku.hk-
dc.identifier.emailWong, ICK: wongick@hku.hk-
dc.identifier.emailLeung, WK: waikleung@hku.hk-
dc.identifier.authorityCheung, KSM=rp02532-
dc.identifier.authorityChan, EW=rp01587-
dc.identifier.authorityWong, ICK=rp01480-
dc.identifier.authorityLeung, WK=rp01479-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1136/gutjnl-2017-314605-
dc.identifier.pmid29089382-
dc.identifier.scopuseid_2-s2.0-85039850298-
dc.identifier.hkuros283494-
dc.identifier.hkuros281967-
dc.identifier.hkuros302522-
dc.identifier.volume67-
dc.identifier.issue1-
dc.identifier.spage28-
dc.identifier.epage35-
dc.identifier.isiWOS:000417778600006-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0017-5749-

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