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Proton Pump Inhibitors Linked with Higher Rates of Gastric Cancer
Santa Cruz, CA: A new study on the use of proton pump inhibitors (PPI) in patients who have been treated successfully for Helicobacter pylori shows that the drugs more than double the risk for gastric cancer.
However, according to the authors of the study, published online in Gut, on October 31, the results show a "clear dose-response and time-response" trend in PPI use and gastric cancer. Therefore, they state, the risk observed suggests the need for "caution when prescribing long-term PPIs to these patients even after successful eradication of H. pylori."
Led by Wai Keung Leung, MBChB, MD, from Queen Mary Hospital, Hong Kong, the study looked at H. pylori infection and its relationship with gastric cancer, among other outcomes. They found a greater associated risk for gastric cancer with longer duration and more frequent use of PPIs.
Despite the study’s limitations, Dr Leung and colleagues state that, to their knowledge, "this is the first study to demonstrate that long-term PPIs use, even after H. pylori eradication therapy, is still associated with an increased risk of gastric cancer. This is likely related to the profound acid suppression of PPIs that worsens atrophic gastritis, particularly in those patients with established gastric atrophy as a result of chronic H. pylori-induced inflammation."
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Proton Pump Inhibitors Gastric Cancer Risk
The study does have several limitations, including the fact that it is observational and was done in Hong Kong, where there are well recognized specific risks for gastric cancer in Asian patients, including diet and high rates of H. pylori.However, according to the authors of the study, published online in Gut, on October 31, the results show a "clear dose-response and time-response" trend in PPI use and gastric cancer. Therefore, they state, the risk observed suggests the need for "caution when prescribing long-term PPIs to these patients even after successful eradication of H. pylori."
Led by Wai Keung Leung, MBChB, MD, from Queen Mary Hospital, Hong Kong, the study looked at H. pylori infection and its relationship with gastric cancer, among other outcomes. They found a greater associated risk for gastric cancer with longer duration and more frequent use of PPIs.
Despite the study’s limitations, Dr Leung and colleagues state that, to their knowledge, "this is the first study to demonstrate that long-term PPIs use, even after H. pylori eradication therapy, is still associated with an increased risk of gastric cancer. This is likely related to the profound acid suppression of PPIs that worsens atrophic gastritis, particularly in those patients with established gastric atrophy as a result of chronic H. pylori-induced inflammation."
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