Open AccessProton pump inhibitors are not associated with an increased risk of colorectal cancer
Author(s) -
Kuiper Josephina G.,
HerkSukel Myrthe P. P.,
Lemmens Valery E. P. P.,
Kuipers Ernst J.,
Herings Ron M. C.
Publication year - 2020
Publication title -
gastrohep
Language(s) - English
Resource type - Journals
ISSN - 1478-1239
DOI - 10.1002/ygh2.409
Subject(s) - medicine , colorectal cancer , odds ratio , cancer , confidence interval , oncology , confounding , risk factor , relative risk , cancer registry
Background The clinical relevance of proton pump inhibitors use as a risk factor for colorectal cancer in humans is still unclear. Aims To investigate the risk of colorectal cancer after the use of proton pump inhibitors within a linked Cancer Registry‐General Practitioner Database cohort. Methods Colorectal cancer patients diagnosed between 2007 and 2014 with at least 6 years of primary care data available prior to diagnosis (index date) were identified and matched to four controls on gender, birth year, general practice and period of primary care data availability. Proton pump inhibitor use was determined in the 6 years prior to the index date and analysed with conditional logistic regression, adjusted for potential confounders. Results 1041 cases (53%) and 4161 controls (53%) ever used a proton pump inhibitor, yielding an odds ratio (OR) of 1.08 (95% confidence interval (CI) 0.97‐1.21). Current use showed the highest OR (1.30 (95% CI 1.16‐1.47)). Long‐term use of proton pump inhibitors (≥4 years) was not associated with colorectal cancer (OR 0.92 (95% CI 0.76‐1.11)). A variation in OR for tumour stage and tumour subsite was observed with the highest OR for stage I tumour (1.28 (95% CI 0.87‐1.87)) and proximal colon (1.19 (95% CI 0.87‐1.63)). Conclusions No increased risk in colorectal cancer was seen with the use of proton pump inhibitors. Current use was associated with an increased likelihood to be diagnosed with colorectal cancer, but this is likely the result of reverse causality. No increased risk was seen for long‐term use of proton pump inhibitors.