Proton Pump Inhibitors and the Risk of Colorectal Cancer
Abstract
INTRODUCTION: Proton pump inhibitor (PPI) use is associated with increased serum gastrin levels and bacterial overgrowth, resulting in more toxic bile salt formation. Concern has risen that these factors may increase the risk of developing colorectal neoplasia. AIM: To investigate the association between the use of PPIs and the risk of colorectal cancer. METHODS: A population-based case-control study was conducted within the Dutch Primary Care Information (IPCI) database over the period 1996-2005. Cases with colorectal cancer were matched with up to 20 controls on age, gender, calendar time, and duration of follow-up prior to diagnosis. Cumulative exposure to PPIs was assessed in the 5 yr prior to diagnosis with a 1-yr lag time analysis. We calculated adjusted odds ratios (OR) with 95% confidence intervals (95% CI) using multivariate, conditional logistic regression analysis. RESULTS: Within the source population of 457,024 persons, we identified 595 colorectal cancer cases. The odds of colorectal cancer were not increased among patients ever using PPIs compared with patients who never used PPIs (OR 0.85, 95% CI 0.63-1.16). Also, the use of PPIs for >365 days was not associated with a greater risk of colorectal cancer (OR 0.79, 95% CI 0.44-1.41) compared with nonusers. The odds of colorectal cancer in neither the right nor the left hemicolon were significantly increased in patients using PPIs. CONCLUSION: The present study indicates no association between PPI use and the risk of colorectal cancer. Larger numbers of long-term PPI users are needed to confirm the absence of a risk-increasing effect of long-term PPI exposure.
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Many studies over the years have not found a direct correlation between PPI use in clinical practice and an increased risk of CRC.
“Nevertheless, it is fundamental to highlight that many studies over the years have not found a direct correlation between PPI use in clinical practice and an increased risk of CRC[154-156].”
From Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified (2019) · cites this paper as [155]
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- Authors
- van Soest, E. M., van Rossum, L. G. M., Dieleman, J. P., van Oijen, M. G. H., Siersema, P. D., Sturkenboom, M. C. J. M., & Kuipers, E. J.
- Affiliations
- Erasmus MC (NL)
- Venue
- The American Journal of Gastroenterology
- Published
- 2008-04
- Volume
- 103
- Issue
- 4
- Pages
- 966-973
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W1992732882
- Cited by
- 80
- References
- 43
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 8 · 2020: 14 · 2019: 1 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 4 · 2013: 7 · 2012: 8
- FWCI
- 3.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
- Keywords
- proton pump inhibitors, colorectal cancer, colorectal neoplasia, serum gastrin, bacterial overgrowth, bile salt toxicity, cancer risk
- MeSH terms
- Female, Humans, Male, Netherlands, Risk, Colorectal Neoplasms, Logistic Models, Case-Control Studies, Proton Pump Inhibitors
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