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Article: Long-term use of proton-pump inhibitors and risk of gastric cancer: a review of the current evidence
Title | Long-term use of proton-pump inhibitors and risk of gastric cancer: a review of the current evidence |
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Authors | |
Keywords | Helicobacter pylori aspirin enterochromaffin-like cells gastric adenocarcinoma gastrin stomach cancer PPIs H. pylori |
Issue Date | 2019 |
Publisher | Sage Publications Ltd. The Journal's web site is located at http://journals.sagepub.com/home/tag |
Citation | Therapeutic Advances in Gastroenterology, 2019, v. 12 How to Cite? |
Abstract | © The Author(s), 2019. Gastric cancer remains one of the leading cancers in the world with a high mortality, particularly in East Asia. Helicobacter pylori infection accounts for the majority of the noncardia gastric cancers by triggering gastric inflammation and subsequent neoplastic progression. Eradication of H. pylori can reduce, but not totally eliminate, subsequent risk of developing gastric cancer. Proton-pump inhibitors (PPIs) are one of the most widely prescribed medications worldwide. With their profound gastric-acid suppression, there are concerns about a possible carcinogenic role in gastric cancer, due to induced hypergastrinemia, gastric atrophy and bacterial overgrowth in the stomach. While randomized clinical trials to establish causality between long-term PPI use and gastric cancer are lacking, current evidence based on observational studies suggests PPIs are associated with an increased gastric cancer risk. However, opinions on causality remain divergent due to unmeasured and possible residual confounding in various studies. Our recent study has showed that even after H. pylori eradication, long-term PPI use is still associated with an increased risk of gastric cancer by more than twofold. Hence, long-term PPIs should be used judiciously after considering individual’s risk–benefit profile, particularly among those with history of H. pylori infection. Further well-designed prospective studies are warranted to confirm the potential role of PPIs in gastric cancer according to baseline gastric histology and its interaction with other chemopreventive agents like aspirin, statins and metformin. |
Persistent Identifier | http://hdl.handle.net/10722/268917 |
ISSN | 2023 Impact Factor: 3.9 2023 SCImago Journal Rankings: 1.189 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Cheung, KSM | - |
dc.contributor.author | Leung, WK | - |
dc.date.accessioned | 2019-04-07T15:08:54Z | - |
dc.date.available | 2019-04-07T15:08:54Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | Therapeutic Advances in Gastroenterology, 2019, v. 12 | - |
dc.identifier.issn | 1756-283X | - |
dc.identifier.uri | http://hdl.handle.net/10722/268917 | - |
dc.description.abstract | © The Author(s), 2019. Gastric cancer remains one of the leading cancers in the world with a high mortality, particularly in East Asia. Helicobacter pylori infection accounts for the majority of the noncardia gastric cancers by triggering gastric inflammation and subsequent neoplastic progression. Eradication of H. pylori can reduce, but not totally eliminate, subsequent risk of developing gastric cancer. Proton-pump inhibitors (PPIs) are one of the most widely prescribed medications worldwide. With their profound gastric-acid suppression, there are concerns about a possible carcinogenic role in gastric cancer, due to induced hypergastrinemia, gastric atrophy and bacterial overgrowth in the stomach. While randomized clinical trials to establish causality between long-term PPI use and gastric cancer are lacking, current evidence based on observational studies suggests PPIs are associated with an increased gastric cancer risk. However, opinions on causality remain divergent due to unmeasured and possible residual confounding in various studies. Our recent study has showed that even after H. pylori eradication, long-term PPI use is still associated with an increased risk of gastric cancer by more than twofold. Hence, long-term PPIs should be used judiciously after considering individual’s risk–benefit profile, particularly among those with history of H. pylori infection. Further well-designed prospective studies are warranted to confirm the potential role of PPIs in gastric cancer according to baseline gastric histology and its interaction with other chemopreventive agents like aspirin, statins and metformin. | - |
dc.language | eng | - |
dc.publisher | Sage Publications Ltd. The Journal's web site is located at http://journals.sagepub.com/home/tag | - |
dc.relation.ispartof | Therapeutic Advances in Gastroenterology | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Helicobacter pylori | - |
dc.subject | aspirin | - |
dc.subject | enterochromaffin-like cells | - |
dc.subject | gastric adenocarcinoma | - |
dc.subject | gastrin | - |
dc.subject | stomach cancer | - |
dc.subject | PPIs | - |
dc.subject | H. pylori | - |
dc.title | Long-term use of proton-pump inhibitors and risk of gastric cancer: a review of the current evidence | - |
dc.type | Article | - |
dc.identifier.email | Cheung, KSM: cks634@hku.hk | - |
dc.identifier.email | Leung, WK: waikleung@hku.hk | - |
dc.identifier.authority | Cheung, KSM=rp02532 | - |
dc.identifier.authority | Leung, WK=rp01479 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1177/1756284819834511 | - |
dc.identifier.pmid | 30886648 | - |
dc.identifier.pmcid | PMC6415482 | - |
dc.identifier.scopus | eid_2-s2.0-85062845860 | - |
dc.identifier.hkuros | 297573 | - |
dc.identifier.volume | 12 | - |
dc.identifier.eissn | 1756-2848 | - |
dc.identifier.isi | WOS:000478876300001 | - |
dc.identifier.issnl | 1756-283X | - |