Long term PPI use associated with gastric cancer in H. pylori-infected subjects — 4 insights

A study, published in Gut, examined the relationship between proton pump inhibitor use and gastric cancer incidence rate among Helicobacter pylori-infected patients.

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Hong Kong, China-based Queen Mary Hospital’s Dr. Wai Keung Leung and colleagues reviewed patients who received outpatient clarithromycin-based triple therapy between 2003 and 2012. Researchers evaluated gastric cancer risk through the Cox proportional hazards model with propensity score adjustment.

Here’s what you should know:

1. Among 63,397 subjects, 153 developed gastric cancer during a median follow-up of 7.6 years.

2. PPI use was associated with gastric cancer risk, while histamine-2 receptor antagonists’ use was not.

3. Risk increased with duration of PPI use.

4. Researchers calculated an adjusted absolute risk difference for PPIs versus non-PPI use of 4.29 excess gastric cancer per 10,000 person-years.

Researchers concluded, “Long-term use of PPIs was still associated with an increased GC risk in subjects even after HP eradication therapy.”

The American Gastroenterological Association responded to the study saying the study’s conclusions are open to debate because the study was a retrospective analysis of two unmatched groups, which may not “have had comparable precancerous gastric changes.”

AGA provided talking points on the study. They are available here.

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