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Br J Cancer. 2017 Apr 25;116(9):1234-1238. doi: 10.1038/bjc.2017.84. Epub 2017 Mar 28.

Acid-suppressing therapies and subsite-specific risk of stomach cancer.

Author information

1
Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen S, Denmark.
2
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20892, USA.

Abstract

BACKGROUND:

Associations of stomach cancer risk with histamine type-2 receptor antagonists (H2RA) and proton-pump inhibitors (PPI) are controversial. We hypothesised that proximal extension of Helicobacter pylori infection from acid suppression would disproportionately increase cancers at proximal subsites.

METHODS:

A total of 1 563 860 individuals in the Danish Prescription Drug Registry first prescribed acid-suppressive drugs 1995-2011 were matched to unexposed population-based controls. Hazard ratios (HR) were calculated by Cox proportional hazard regression for stomach cancers diagnosed more than one year after first prescription.

RESULTS:

There were 703 stomach cancers among H2RA-exposed individuals and 1347 among PPI-exposed. Restricted to individuals with five or more prescriptions, subsite-specific HRs for H2RA and PPI were 4.1 and 6.4 for proximal subsites vs 8.0 and 10.3 for distal subsites, respectively.

CONCLUSIONS:

Moderate exposures to acid-suppressive drugs did not favour proximal tumour localisation. Given confounding by indication, these findings do not resolve potential contribution to gastric carcinogenesis overall.

PMID:
28350791
PMCID:
PMC5418456
DOI:
10.1038/bjc.2017.84
[Indexed for MEDLINE]
Free PMC Article

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