To Örebro University

oru.seÖrebro University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Maintenance proton pump inhibitor use and risk of colorectal cancer: a Swedish retrospective cohort study
Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden .
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Capio Saint Göran Hospital, Stockholm, Sweden.
Show others and affiliations
2024 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 14, no 7, article id e079591Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: We aimed to evaluate the risk of colorectal adenocarcinoma (CRA) associated with long-term use of proton pump inhibitors (PPIs) in a large nationwide cohort.

DESIGN: Retrospective cohort study.

SETTING: This research was conducted at the national level, encompassing the entire population of Sweden.

PARTICIPANTS: This study utilised Swedish national registries to identify all adults who had ≥180 days of cumulative PPI use between July 2005 and December 2012, excluding participants who were followed up for less than 1 year. A total of 754 118 maintenance PPI users were included, with a maximum follow-up of 7.5 years.

INTERVENTIONS: Maintenance PPI use (cumulative≥180 days), with a comparator of maintenance histamine-2 receptor antagonist (H2RA) use.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was the risk of CRA, presented as standardised incidence ratios (SIRs) with 95% confidence intervals (CIs). Subgroup analyses were performed to explore the impact of indications, tumour locations, tumour stages and the duration of follow-up. A multivariable Poisson regression model was fitted to estimate the incidence rate ratios (IRRs) and 95% CIs of PPI versus H2RA use.

RESULTS: Maintenance PPI users exhibited a slightly elevated risk of CRA compared to the general population (SIR 1.10, 95% CI=1.06 to 1.13) for both men and women. Individuals aged 18-39 (SIR 2.79, 95% CI=1.62 to 4.47) and 40-49 (SIR 2.02, 95% CI=1.65 to 2.45) had significantly higher risks than the general population. Right-sided CRA showed a higher risk compared to the general population (SIR 1.26, 95% CI=1.20 to 1.32). There was no significant difference in the risk of CRA between maintenance PPI users and maintenance H2RA users (IRR 1.05, 95% CI=0.87 to 1.27, p<0.05).

CONCLUSIONS: Maintenance PPI use may be associated with an increased risk of CRA, but a prolonged observation time is needed.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024. Vol. 14, no 7, article id e079591
Keywords [en]
CLINICAL PHARMACOLOGY, EPIDEMIOLOGIC STUDIES, GASTROENTEROLOGY, Gastrointestinal tumours, REGISTRIES, Risk Factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-114609DOI: 10.1136/bmjopen-2023-079591ISI: 001265212100035PubMedID: 38960460Scopus ID: 2-s2.0-85197662994OAI: oai:DiVA.org:oru-114609DiVA, id: diva2:1881873
Funder
Swedish Society of Medicine, SLS-788731; SLS-78875; SLS-783091Swedish Research Council, 2020-01058Available from: 2024-07-04 Created: 2024-07-04 Last updated: 2024-08-21Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records

Fall, Katja

Search in DiVA

By author/editor
Fall, Katja
By organisation
School of Medical Sciences
In the same journal
BMJ Open
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 24 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf