Centre for Public Health, Queen's University Belfast, Belfast, UK.
Belfast Health and Social Care Trust, Belfast, UK.
Br J Cancer. 2020 Jul;123(2):307-315. doi: 10.1038/s41416-020-0860-4. Epub 2020 May 5.
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.
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.
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).
Overall, we observed little consistent evidence of an increased risk of gastric cancer with PPI use.
研究表明，质子泵抑制剂（PPI）和组胺 2 受体拮抗剂的使用者胃癌风险增加，这对胃酸抑制的安全性提出了质疑。因此，我们在苏格兰初级保健临床信息学单位（PCCIU）数据库中进行了病例对照研究，并在英国生物库中进行了队列研究。
在 PCCIU 中，将五个对照与 1999-2011 年诊断的病例相匹配，并从全科医生记录中确定药物。使用条件逻辑回归计算比值比（OR）和 95%置信区间（CI）。在英国生物库中，药物在 2006-2010 年入组时自我报告，通过癌症登记处确定胃癌直到 2014 年。使用 Cox 回归计算危险比（HR）。
PCCIU 包含 1119 例病例和 5394 例对照。英国生物库包含 471779 名参与者中的 250 例病例。在 PCCIU 和英国生物库中，应用 1 年滞后时，PPI 用户的胃癌风险较高（调整后的 OR=1.49，95%CI 1.24，1.80；调整后的 HR=1.28，95%CI 0.86，1.90），但当使用 2 年滞后时，这些关联减弱（调整后的 OR=1.13，95%CI 0.91，1.40；调整后的 HR=1.15，95%CI 0.73，1.82）。
总体而言，我们观察到 PPI 使用与胃癌风险增加的证据很少一致。
