Duration of use of proton pump inhibitors and the risk of gastric and oesophageal cancer |
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| Institution: | 1. Centre for Translational Microbiome Research, Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden;2. Science for Life Laboratory (SciLifeLab), Stockholm, Sweden;3. Department of Head and Skin, Faculty of Medicine, Ghent University, Ghent, Belgium;4. Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;5. School of Cancer and Pharmaceutical Sciences, King’s College London, United Kingdom;1. Department of Surgery, Division of Urology, Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;2. Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA;3. Surgery Section, Durham VA Health Care System, Durham, NC, USA;4. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA;5. Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA;6. Institute for Translational Epidemiology, and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA;7. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA;1. Programa de Hematologia-Oncologia Pediátrica - PHOP, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil;2. Divisão de Vigilância e Análise de Situação, Coordenação de Prevenção e Vigilância, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil;3. Secretaria Estadual de Saúde da Paraíba, Registro de Câncer de Base Populacional de João Pessoa, Brazil;4. Secretaria Municipal de Saúde de Recife, Registro de Câncer de Base Populacional de Recife, Brazil;5. Secretaria de Saúde do Estado do Ceará, Registro de Câncer de Base Populacional de Fortaleza, Brazil;6. Secretaria Estadual de Saúde de Minas Gerais, Superintendência de Epidemiologia, Registro de Câncer de Base Populacional de Belo Horizonte, Brazil;7. Hospital de Câncer de Barretos, Fundação Pio XII, Registro de Câncer de Base Populacional de Barretos, Brazil;8. Coordenação Estadual de Atenção Oncológica, Secretaria Estadual de Saúde do Pará, Registro de Câncer de Base Populacional de Belém, Brazil;9. Secretaria Municipal de Saúde de Curitiba, Registro de Câncer de Base Populacional de Curitiba, Brazil;10. Secretaria Estadual de Saúde, Hospital Gov. João Alves Filho, Registro de Câncer de Base Populacional de Aracaju, Brazil;11. Fundação Centro de Controle de Oncologia, Registro de Câncer de Base Populacional de Manaus, Brazil;12. Associação de Combate ao Câncer de Goiás, Registro de Câncer de Base Populacional de Goiânia, Brazil;13. Secretaria Estadual de Saúde do Espírito Santo, Registro de Câncer de Base Populacional de Espírito Santo, Brazil;14. Faculdade de Saúde Pública da Universidade de São Paulo, Registro de Câncer de Base Populacional de São Paulo, Brazil;15. Secretaria Municipal de Saúde de Porto Alegre, Registro de Câncer de Base Populacional de Porto Alegre, Brazil;p. Secretaria de Estado de Saúde do Mato Grosso, Superintendência de Vigilância em Saúde, Registro de Câncer de Base Populacional de Cuiabá, Brazil;q. Fundação Hospital Amaral Carvalho, Registro de Câncer de Base Populacional de Jahu, Brazil;1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark;2. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA;3. Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark;1. Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China;2. Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing China;3. State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing 210023, China;4. State Key Laboratory of Bioelectronics, Southeast University, Nanjing, China;1. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom;2. Clinical Effectiveness Unit, The Royal College of Surgeons of England, United Kingdom;3. Department of Urology, Guy’s and St Thomas’ NHS Foundation Trust, United Kingdom;4. Department of Urology, The Christie NHS Foundation Trust Manchester, United Kingdom;5. Department of Urology, Salford Royal NHS Foundation Trust, United Kingdom;6. Department of Oncology, University College London Hospitals, United Kingdom;7. Department of Cancer Epidemiology, Population, and Global Health, King’s College London, United Kingdom;8. Department of Radiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, United Kingdom;1. Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden;2. Centre for Translational Microbiome Research, Department of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden;3. Science for Life Laboratory, Stockholm, Sweden;1. Centre for Translational Microbiome Research, Department of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden;2. Science for Life Laboratory, Stockholm, Sweden;1. Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden;2. Division of Cancer Studies, King’s College London, United Kingdom |
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| Abstract: | BackgroundThere is increasing interest in the potential association between proton pump inhibitors (PPIs) and the risk of gastric and oesophageal cancer, yet the effect of duration of treatment needs clarification.MethodsThis Swedish population-based cohort study assessed the influence of time since initiation of PPI treatment on the risk of gastric and oesophageal cancer, presented as standardised incidence ratios and 95% confidence intervals.ResultsThe risk of gastric and oesophageal cancer during the first year was 7–10 times higher than the background population, and remained 24–202% increased without any decrease over time after the first year.ConclusionPPI use was associated with an increased risk of gastric and oesophageal cancer and the risk remained increased over follow-up. These results support our original hypothesis that use of PPIs may be a risk factor for gastric and oesophageal cancer in the general population of maintenance users, independent of underlying indications. |
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| Keywords: | Stomach neoplasms Esophageal neoplasms Neoplasms Proton pump inhibitors Adenocarcinoma Carcinoma Squamous cell |
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