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 J Lee; Pauline A J Vissers; Chris R Cardwell

doi:10.1038/s41416-020-0860-4

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 J Lee, Pauline A J Vissers, Chris R Cardwell

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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 language	English
Journal	British Journal of Cancer
Early online date	05 May 2020
DOIs	https://doi.org/10.1038/s41416-020-0860-4
Publication status	Early online date - 05 May 2020

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Use of proton pump inhibitors and histamine-2 receptor antagonists and risk of gastric cancer in two population-based studies
© 2020 The Authors. This work is made available online in accordance with the publisher’s policies. Please refer to any applicable terms of use of the publisher.
Accepted author manuscript, 851 KBLicence: Unspecified

Medications, sex hormones and reproductive factors in relation to gastro-oesophageal cancer risk and survival
Liu, P. (Author), Cardwell, C. (Supervisor), Coleman, H. (Supervisor) & McMenamin, U. (Supervisor), Dec 2021
Student thesis: Doctoral Thesis › Doctor of Philosophy

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

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.",

author = "Peipei Liu and McMenamin, {{\'U}na C} and Johnston, {Brian T} and Peter Murchie and Lisa Iversen and Lee, {Amanda J} and Vissers, {Pauline A J} and Cardwell, {Chris R}",

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doi = "10.1038/s41416-020-0860-4",

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journal = "British Journal of Cancer",

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T1 - Use of proton pump inhibitors and histamine-2 receptor antagonists and risk of gastric cancer in two population-based studies

AU - Liu, Peipei

AU - McMenamin, Úna C

AU - Johnston, Brian T

AU - Murchie, Peter

AU - Iversen, Lisa

AU - Lee, Amanda J

AU - Vissers, Pauline A J

AU - Cardwell, Chris R

PY - 2020/5/5

Y1 - 2020/5/5

N2 - 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.

AB - 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.

U2 - 10.1038/s41416-020-0860-4

DO - 10.1038/s41416-020-0860-4

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SN - 0007-0920

JO - British Journal of Cancer

JF - British Journal of Cancer

ER -

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

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Medications, sex hormones and reproductive factors in relation to gastro-oesophageal cancer risk and survival

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