
Long-term proton pump inhibitor use and the incidence of gastric cancer: A systematic review and meta-analysis
Author(s) -
JuLi Lin,
Lin Ji,
ChaoHui Zheng,
JianWei Xie,
Jia-Bin Wang,
Jun Lü,
QiYue Chen,
LongLong Cao,
Lin Ma,
Ping Li,
ChangMing Huang
Publication year - 2020
Publication title -
journal of gastric surgery
Language(s) - English
Resource type - Journals
eISSN - 2704-9108
pISSN - 2704-8284
DOI - 10.36159/jgs.v2i1.17
Subject(s) - cancer , medicine , relative risk , incidence (geometry) , proton pump inhibitor , confidence interval , gastroenterology , physics , optics
Background: There are controverted whether the long-term use of proton pump inhibitors (PPI) will increase the risk of gastric cancer. We performed a meta-analysis to assess the risk of gastric cancer in PPI users compared with non-PPI users. Methods: The main inclusion criteria were original studies reporting the incidence of gastric cancer in PPI users compared with non-PPI users. Key outcomes were the risk ratios (RR) for gastric cancer in association with PPI users or non-PPI users. Results: We analyzed data from 8 studies, comprising more than 927,684 patients. The risk of gastric cancer in PPI users was significantly higher than in non-PPI users [RR= 2.10, 95% CI (1.17-3.97)]. The risk of gastric cancer was similar between the 2 groups when the duration was ≤1 year [RR= 2.18, 95% CI (0.66-7.11)]. While the risk of gastric cancer for PPI users was higher than in non-PPI users when the duration was between 1-3 years, ≥1 year, ≥3 years and ≥5 years. The risk of non-cardiac gastric cancer for PPI users was higher than for non-PPI users [RR= 2.66, 95% CI (1.66 -4.27)], and the risk of non-cardiac gastric cancer for PPI users was higher than for non-PPI users when the duration ≥1 year [RR= 1.99, 95% CI (1.03-3.83)], but the risk for cardiac gastric cancer was similar between the 2 groups [RR= 1.86, 95% CI (0.71-4.89)]. Conclusions: We found the long-term use of PPI (duration ≥1 year) was significantly associated with a higher risk of non-cardiac gastric cancer.