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. 2018 Aug;27(8):926-930.
doi: 10.1002/pds.4576. Epub 2018 Jun 20.

Use of Proton Pump Inhibitors and Risk of Pancreatic Cancer


Use of Proton Pump Inhibitors and Risk of Pancreatic Cancer

Blánaid Hicks et al. Pharmacoepidemiol Drug Saf. .


Purpose: Preclinical studies have suggested that proton pump inhibitors (PPIs) may increase pancreatic cancer risk; however, epidemiological studies are few, with conflicting results. This spurred us to evaluate whether PPI use is associated with an increased risk of pancreatic cancer in a large population-based study.

Methods: We conducted a nationwide case-control study using data from Danish demographic and health care registries. All patients with a first cancer diagnosis of pancreatic cancer between 2000 and 2015 were identified from the Danish Cancer Registry and age-matched, sex-matched, and calendar-matched 1:20 to population controls using risk set sampling. Conditional logistic regression was applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for pancreatic cancer associated with PPI use, adjusting for potential confounders. Secondary analyses examined dose-response patterns and associations with individual PPIs as well as with histamine-2-receptor antagonists.

Results: Ever use of PPIs occurred among 27.8% of 6921 pancreatic cancer cases and 25.4% of 34 695 matched controls, yielding a neutral adjusted OR of 1.04 (95% CI 0.97-1.11). Odds ratios were also close to unity in analyses of high use of PPIs (≥1000 DDDs; OR, 0.92 95% CI 0.80-1.07). There was no evidence of a dose-response relationship, with ORs close to unity across categories, including for those with the highest cumulative use (>2000 DDDs; OR, 1.03 95% CI 0.84-1.26). Analyses of subgroups as well as individual types of PPI and of histamine-2-receptor antagonists use also returned neutral associations.

Conclusions: In this large nationwide case-control study, PPI use was not associated with an increased risk of pancreatic cancer.

Keywords: pancreatic cancer; pharmacoepidemiology; proton pump inhibitors.

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