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Conference Paper: Statin use and gastric cancer risk in Helicobacter pylori-eradicated patients: a territory-wide study with propensity score matching

TitleStatin use and gastric cancer risk in Helicobacter pylori-eradicated patients: a territory-wide study with propensity score matching
Authors
Issue Date2019
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/
Citation
The 24th Medical Research Conference, Hong Kong, 19 January 2019. In Hong Kong Medical Journal, 2019, v. 25 n. 1, Suppl. 1, p. 13, abstract no. 9 How to Cite?
AbstractIntroduction: Despite successful Helicobacter pylori eradication, some individuals still progress to develop gastric cancer (GC). Although statins were shown to reduce GC risk, the results are largely confounded by H pylori status. The aim of this study was to investigate the effects of statins on GC development in H pylori–eradicated patients. Methods: This was a cohort study using a territory-wide electronic healthcare database. All adult patients (≥18 years) who were prescribed clarithromycin-based triple therapy for H pylori infection between 2003 and 2012 were recruited. The observation period commenced from the date of H pylori therapy and follow-up was censored at GC diagnosis, death, or study end date (December 2015). Statin use was defined as >180-day use during the study period. Exclusion criteria included GC diagnosed within the first year of H pylori therapy, a history of GC or gastrectomy, and failure of H pylori eradication. The subdistribution hazard ratio (SHR) of GC with statin use was estimated by competing risk regression with propensity score (PS) matching for other variables (age, sex, co-morbidities, and other medications). Results: A total of 63 605 patients were recruited, with the mean (± standard deviation) age of receiving triple therapy being 55.6 ± 14.6 years. There were 29 640 (46.6%) men and 15 990 (25.1%) statin users. During a median follow-up of 7.6 years (interquartile range, 5.1-10.3 years), 169 (0.27%) of 63 605 patients developed GC (crude incidence rate: 3.5 per 10 000 person-years for the whole cohort; 2.4 vs 3.8 per 10 000 person-years for statin and non-statin users, respectively). A total of 22 870 patients were available for PS matching. A lower GC risk was observed in statin users (SHR=0.34; 95% confidence interval [CI]=0.19-0.61), with a PS-adjusted absolute risk difference between statin and non-statin use being 2.6 fewer GC (95% CI=1.56-3.12) per 10 000 person-years. A lower GC risk was observed with a longer duration of statin use (SHR=0.46; 95% CI= 0.25-0.86 for <5 years of use and SHR 0.43; 95% CI=0.29-0.66 for ≥5 years of use, Ptrend<0.001). In addition, the SHR of GC with every 100 increases in cumulative defined daily doses of statins was 0.90 (95% CI=0.81-0.99). Conclusions: Statin use is associated with a significantly lower GC risk among H pylori–eradicated patients, in a duration- and dose-response manner.
Persistent Identifierhttp://hdl.handle.net/10722/275855
ISSN
2020 Impact Factor: 2.227
2015 SCImago Journal Rankings: 0.279

 

DC FieldValueLanguage
dc.contributor.authorCheung, KSM-
dc.contributor.authorChan, EWY-
dc.contributor.authorWong, ASY-
dc.contributor.authorChen, L-
dc.contributor.authorSeto, WKW-
dc.contributor.authorWong, ICK-
dc.contributor.authorLeung, WK-
dc.date.accessioned2019-09-10T02:51:01Z-
dc.date.available2019-09-10T02:51:01Z-
dc.date.issued2019-
dc.identifier.citationThe 24th Medical Research Conference, Hong Kong, 19 January 2019. In Hong Kong Medical Journal, 2019, v. 25 n. 1, Suppl. 1, p. 13, abstract no. 9-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/275855-
dc.description.abstractIntroduction: Despite successful Helicobacter pylori eradication, some individuals still progress to develop gastric cancer (GC). Although statins were shown to reduce GC risk, the results are largely confounded by H pylori status. The aim of this study was to investigate the effects of statins on GC development in H pylori–eradicated patients. Methods: This was a cohort study using a territory-wide electronic healthcare database. All adult patients (≥18 years) who were prescribed clarithromycin-based triple therapy for H pylori infection between 2003 and 2012 were recruited. The observation period commenced from the date of H pylori therapy and follow-up was censored at GC diagnosis, death, or study end date (December 2015). Statin use was defined as >180-day use during the study period. Exclusion criteria included GC diagnosed within the first year of H pylori therapy, a history of GC or gastrectomy, and failure of H pylori eradication. The subdistribution hazard ratio (SHR) of GC with statin use was estimated by competing risk regression with propensity score (PS) matching for other variables (age, sex, co-morbidities, and other medications). Results: A total of 63 605 patients were recruited, with the mean (± standard deviation) age of receiving triple therapy being 55.6 ± 14.6 years. There were 29 640 (46.6%) men and 15 990 (25.1%) statin users. During a median follow-up of 7.6 years (interquartile range, 5.1-10.3 years), 169 (0.27%) of 63 605 patients developed GC (crude incidence rate: 3.5 per 10 000 person-years for the whole cohort; 2.4 vs 3.8 per 10 000 person-years for statin and non-statin users, respectively). A total of 22 870 patients were available for PS matching. A lower GC risk was observed in statin users (SHR=0.34; 95% confidence interval [CI]=0.19-0.61), with a PS-adjusted absolute risk difference between statin and non-statin use being 2.6 fewer GC (95% CI=1.56-3.12) per 10 000 person-years. A lower GC risk was observed with a longer duration of statin use (SHR=0.46; 95% CI= 0.25-0.86 for <5 years of use and SHR 0.43; 95% CI=0.29-0.66 for ≥5 years of use, Ptrend<0.001). In addition, the SHR of GC with every 100 increases in cumulative defined daily doses of statins was 0.90 (95% CI=0.81-0.99). Conclusions: Statin use is associated with a significantly lower GC risk among H pylori–eradicated patients, in a duration- and dose-response manner.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.relation.ispartof24th Medical Research Conference, Hong Kong-
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.titleStatin use and gastric cancer risk in Helicobacter pylori-eradicated patients: a territory-wide study with propensity score matching-
dc.typeConference_Paper-
dc.identifier.emailCheung, KSM: cks634@hku.hk-
dc.identifier.emailChan, EWY: ewchan@hku.hk-
dc.identifier.emailChen, L: equalclj@hku.hk-
dc.identifier.emailSeto, WKW: wkseto@hku.hk-
dc.identifier.emailWong, ICK: wongick@hku.hk-
dc.identifier.emailLeung, WK: waikleung@hku.hk-
dc.identifier.authorityCheung, KSM=rp02532-
dc.identifier.authorityChan, EWY=rp01587-
dc.identifier.authoritySeto, WKW=rp01659-
dc.identifier.authorityWong, ICK=rp01480-
dc.identifier.authorityLeung, WK=rp01479-
dc.identifier.hkuros302538-
dc.identifier.volume25-
dc.identifier.issue1, Suppl. 1-
dc.identifier.spage13, abstract no. 9-
dc.identifier.epage13, abstract no. 9-
dc.publisher.placeHong Kong-
dc.identifier.issnl1024-2708-

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