| Title: | Proton Pump Inhibitors and Gastric Cancer: A Large-Scale Propensity Score-Matched Analysis. |
| Journal: | Gut and Liver |
| Published: | 25 Jun 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42349925/ |
| DOI: | https://doi.org/10.5009/gnl250603 |
Publication 20532
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Abstract
Background/Aims: We aimed to elucidate whether proton pump inhibitor (PPI) users are at increased risk of gastric cancer compared with non-PPI users or histamine-2 receptor antagonist (H2RA) users.</p>
Methods: A population-based cohort study was conducted using data from the UK Biobank from 1990 to 2016. We compared the incidence of gastric cancer after a minimum of 1-year drug exposure between PPI users and non-PPI or H2RA users using Cox proportional hazards models. Secondary analyses assessed the duration and dose-response associations. Sensitivity analyses incorporating various matching ratios, extended lag periods, and propensity score stratification were performed.</p>
Results: After large-scale propensity score matching, we included 42,732 new PPI users, 42,732 non-PPI users, and 4,762 new H2RA users. During a median follow-up of 6.7 years, PPI users had a 2.32-fold higher risk of gastric cancer than non-PPI users (hazard ratio [HR], 2.324; 95% confidence interval [CI], 1.646 to 3.282), with numbers needed to harm of 488 and 442 at 2 and 4 years, respectively. Compared with H2RA users, PPI users also had a significantly higher incidence of gastric cancer (HR, 5.343; 95% CI, 1.557 to 18.335). The risk of gastric cancer tended to increase with a longer cumulative duration of PPI use and higher cumulative doses of PPIs. Moreover, these results remained robust after adjustments for various lag periods, matching ratios, and propensity score stratification.</p>
Conclusions: PPI use was associated with a higher incidence of gastric cancer, albeit with a low absolute risk. Therefore, long-term PPI use should be considered cautiously, even in regions with a low risk of gastric cancer.</p>
15 Keywords
- Aged
- Cohort Studies
- Dose-Response Relationship, Drug
- Female
- Histamine H2 Antagonists
- Humans
- Incidence
- Male
- Middle Aged
- Propensity Score
- Proportional Hazards Models
- Proton Pump Inhibitors
- Risk Factors
- Stomach Neoplasms
- United Kingdom
6 Authors
- Cheal Wung Huh
- Nak-Hoon Son
- So Hyeon Gwon
- Hee Byung Koh
- Hae-Ryong Yun
- Da Hyun Jung
1 Application
| Application ID | Title |
|---|---|
| 73873 | The study of biological, behavioral, ethnic , environmental, and genetic factors affecting the incidence, progression of CKD, and the risk of developing adverse outcomes in patients with CKD |
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