What is the role of proton pump inhibitors (PPIs) in the etiology of gastric cancer?

Updated: Feb 23, 2021
  • Author: Elwyn C Cabebe, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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A study by Cheung et al found that risk of gastric cancer was increased in patients who used proton pump inhibitors (PPIs) long-term after successful treatment for H pylori infection. [21] In the study, which included 63,397 patients from a territory-wide Hong Kong health database with a median follow-up of 7.6 years, PPIs use was associated with more than a doubled risk of gastric cancer (hazard ratio [HR] 2.44; 95% confidence index [CI], 1.42 to 4.20). The risk increased with duration of PPIs use, as follows:

  • ≥1 year - HR 5.04 (95% CI 1.23–20.61)
  • ≥2 years - HR 6.65 (95% CI 1.62–27.26)
  • ≥3 years - HR 8.34 (95% CI 2.02–34.41) 

The relevance of this study to clinical practice remains uncertain, howevver, as the results could be due to residual confounding or detection bias. [22]

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