Association between proton pump inhibitor use and the risk of pancreatic cancer: A Korean nationwide cohort study
Proton pump inhibitor (PPI) therapy causes hypergastrinemia, which could promote the development and progression of pancreatic cancer. Accordingly, this study aimed to investigate the association between PPI exposure and the risk of pancreatic cancer. We conducted a twelve-year longitudinal populati...
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| description | Proton pump inhibitor (PPI) therapy causes hypergastrinemia, which could promote the development and progression of pancreatic cancer. Accordingly, this study aimed to investigate the association between PPI exposure and the risk of pancreatic cancer.
We conducted a twelve-year longitudinal population-based study (2002-2013) using the Korean National Health Insurance Corporation claims database merged with national health examination data. The study cohort included 453,655 cancer-free individuals in January 2007 (index date). Incident pancreatic cancer was assessed throughout follow up until December 2013. The exposure to PPIs before the index date was assessed using a standardized Defined Daily Dose (DDD) system. We calculated the hazard ratios (HRs) and their 95% confidence intervals (CIs) for pancreatic cancer risk associated with cumulative PPI use using Cox proportional hazard regression models.
There were 3,086 cases of pancreatic cancer during the period of 2,920,000 person-years. PPI users exceeding 60 DDDs were at a higher risk of pancreatic cancer compared with non-users (HR, 1.34; 95% CI, 1.04-1.72). Subgroup analyses revealed that a significant association existed between PPI use and pancreatic cancer in low risk groups including individuals who were female, engaged in healthy lifestyle habits, and had no history of diabetes or chronic pancreatitis.
Exposure to PPI appears to increase the risk of pancreatic cancer, independent of conventional risk factors. |
| doi_str_mv | 10.1371/journal.pone.0203918 |
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We conducted a twelve-year longitudinal population-based study (2002-2013) using the Korean National Health Insurance Corporation claims database merged with national health examination data. The study cohort included 453,655 cancer-free individuals in January 2007 (index date). Incident pancreatic cancer was assessed throughout follow up until December 2013. The exposure to PPIs before the index date was assessed using a standardized Defined Daily Dose (DDD) system. We calculated the hazard ratios (HRs) and their 95% confidence intervals (CIs) for pancreatic cancer risk associated with cumulative PPI use using Cox proportional hazard regression models.
There were 3,086 cases of pancreatic cancer during the period of 2,920,000 person-years. PPI users exceeding 60 DDDs were at a higher risk of pancreatic cancer compared with non-users (HR, 1.34; 95% CI, 1.04-1.72). Subgroup analyses revealed that a significant association existed between PPI use and pancreatic cancer in low risk groups including individuals who were female, engaged in healthy lifestyle habits, and had no history of diabetes or chronic pancreatitis.
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We conducted a twelve-year longitudinal population-based study (2002-2013) using the Korean National Health Insurance Corporation claims database merged with national health examination data. The study cohort included 453,655 cancer-free individuals in January 2007 (index date). Incident pancreatic cancer was assessed throughout follow up until December 2013. The exposure to PPIs before the index date was assessed using a standardized Defined Daily Dose (DDD) system. We calculated the hazard ratios (HRs) and their 95% confidence intervals (CIs) for pancreatic cancer risk associated with cumulative PPI use using Cox proportional hazard regression models.
There were 3,086 cases of pancreatic cancer during the period of 2,920,000 person-years. PPI users exceeding 60 DDDs were at a higher risk of pancreatic cancer compared with non-users (HR, 1.34; 95% CI, 1.04-1.72). Subgroup analyses revealed that a significant association existed between PPI use and pancreatic cancer in low risk groups including individuals who were female, engaged in healthy lifestyle habits, and had no history of diabetes or chronic pancreatitis.
Exposure to PPI appears to increase the risk of pancreatic cancer, independent of conventional risk factors.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alcohol</subject><subject>Alcohol use</subject><subject>Archives & records</subject><subject>Biology and Life Sciences</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Consortia</subject><subject>Databases, Factual</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Disease</subject><subject>Drug dosages</subject><subject>Evolution & development</subject><subject>Exposure</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Inhibitors</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - epidemiology</subject><subject>Pancreatic Neoplasms - etiology</subject><subject>Pancreatitis</subject><subject>Population</subject><subject>Population studies</subject><subject>Proportional Hazards Models</subject><subject>Proton pump inhibitors</subject><subject>Proton Pump Inhibitors - administration & dosage</subject><subject>Proton Pump Inhibitors - adverse effects</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Republic of Korea - epidemiology</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Risk 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between proton pump inhibitor use and the risk of pancreatic cancer: A Korean nationwide cohort study</title><author>Hwang, In Cheol ; Chang, Jooyoung ; Park, Sang Min</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-1c940b841ff75fb45f4bb2df42c1b5232d0e39d429a0d9a049aa84a0dafabaac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alcohol</topic><topic>Alcohol use</topic><topic>Archives & records</topic><topic>Biology and Life Sciences</topic><topic>Body mass index</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Clinical medicine</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Consortia</topic><topic>Databases, Factual</topic><topic>Diabetes</topic><topic>Diabetes 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titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hwang, In Cheol</au><au>Chang, Jooyoung</au><au>Park, Sang Min</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between proton pump inhibitor use and the risk of pancreatic cancer: A Korean nationwide cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-09-12</date><risdate>2018</risdate><volume>13</volume><issue>9</issue><spage>e0203918</spage><epage>e0203918</epage><pages>e0203918-e0203918</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Proton pump inhibitor (PPI) therapy causes hypergastrinemia, which could promote the development and progression of pancreatic cancer. Accordingly, this study aimed to investigate the association between PPI exposure and the risk of pancreatic cancer.
We conducted a twelve-year longitudinal population-based study (2002-2013) using the Korean National Health Insurance Corporation claims database merged with national health examination data. The study cohort included 453,655 cancer-free individuals in January 2007 (index date). Incident pancreatic cancer was assessed throughout follow up until December 2013. The exposure to PPIs before the index date was assessed using a standardized Defined Daily Dose (DDD) system. We calculated the hazard ratios (HRs) and their 95% confidence intervals (CIs) for pancreatic cancer risk associated with cumulative PPI use using Cox proportional hazard regression models.
There were 3,086 cases of pancreatic cancer during the period of 2,920,000 person-years. PPI users exceeding 60 DDDs were at a higher risk of pancreatic cancer compared with non-users (HR, 1.34; 95% CI, 1.04-1.72). Subgroup analyses revealed that a significant association existed between PPI use and pancreatic cancer in low risk groups including individuals who were female, engaged in healthy lifestyle habits, and had no history of diabetes or chronic pancreatitis.
Exposure to PPI appears to increase the risk of pancreatic cancer, independent of conventional risk factors.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30208110</pmid><doi>10.1371/journal.pone.0203918</doi><tpages>e0203918</tpages><orcidid>https://orcid.org/0000-0002-7498-4829</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Alcohol Alcohol use Archives & records Biology and Life Sciences Body mass index Cancer Cancer therapies Care and treatment Clinical medicine Cohort analysis Cohort Studies Confidence intervals Consortia Databases, Factual Diabetes Diabetes mellitus Disease Drug dosages Evolution & development Exposure Female Gastroenterology Health risk assessment Health risks Hepatology Humans Inhibitors Longitudinal Studies Male Medical diagnosis Medicine Medicine and Health Sciences Meta-analysis Middle Aged Pancreatic cancer Pancreatic Neoplasms - epidemiology Pancreatic Neoplasms - etiology Pancreatitis Population Population studies Proportional Hazards Models Proton pump inhibitors Proton Pump Inhibitors - administration & dosage Proton Pump Inhibitors - adverse effects Regression analysis Regression models Republic of Korea - epidemiology Risk analysis Risk Factors Risk groups Statistical analysis Studies Subgroups Systematic review Tobacco Ulcers |
| title | Association between proton pump inhibitor use and the risk of pancreatic cancer: A Korean nationwide cohort study |
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