한빛사논문
- 조회573
Seung In Seo1,2, Chan Hyuk Park3, Seng Chan You4, Jae Young Kim5, Kyung Joo Lee5, Jinseob Kim6, Yerim Kim7, Jong Jin Yoo1, Won-Woo Seo1, Hyung Seok Lee8, Woon Geon Shin1,2
1Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
2Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea
3Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
4Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
5University Industry Foundation, Hallym University, Chuncheon, South Korea
6Department of Epidemiology, School of Public Health, Seoul National University, Seoul, South Korea
7Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
8Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
Correspondence to Professor Woon Geon Shin.
Abstract
Objective
The association between proton pump inhibitor (PPI) use and gastric cancer related to Helicobacter pylori eradication has not been fully investigated in geographical regions with high risk of gastric cancer. We aimed to evaluate the association between PPIs and gastric cancer in Korea.
Design
This study analysed the original and common data model versions of the Korean National Health Insurance Service database from 2002 to 2013. We compared the incidence rates of gastric cancer after 1-year drug exposure, between new users of PPIs and other drugs excluding PPIs, by Cox proportional hazards model. We also analysed the incidence of gastric cancer among PPI users after H. pylori eradication.
Results
The analysis included 11 741 patients in matched PPI and non-PPI cohorts after large-scale propensity score matching. During a median follow-up of 4.3 years, PPI use was associated with a 2.37-fold increased incidence of gastric cancer (PPI≥30 days vs non-PPI; 118/51 813 person-years vs 40/49 729 person-years; HR 2.37, 95% CI 1.56 to 3.68, p=0.001). The incidence rates of gastric cancer showed an increasing trend parallel to the duration of PPI use. In H. pylori-eradicated subjects, the incidence of gastric cancer was significantly associated with PPI use over 180 days compared with the non-PPI group (PPI≥180 days vs non-PPI; 30/12 470 person-years vs 9/7814 person-years; HR 2.22, 95% CI 1.05 to 4.67, p=0.036).
Conclusion
PPI use was associated with gastric cancer, regardless of H. pylori eradication status. Long-term PPIs should be used with caution in high-risk regions for gastric cancer.
논문정보
- Research article
- 2021년 05월 (BRIC 등록일 2021-05-28)
- 국내 연구진
- 의약학 > 응용의학
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