Author:
Babic Ana,Zhang Xuehong,Morales-Oyarvide Vicente,Yuan Chen,Khalaf Natalia,Khalili Hamed,Lochhead Paul,Chan Andrew T.,Ogino Shuji,Wolpin Brian M.,Wu Kana,Fuchs Charles S.,Giovannucci Edward L.,Stampfer Meir J.,Ng Kimmie
Abstract
Abstract
Background
Despite several plausible biological mechanisms linking proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) with colorectal tumorigenesis, their association with risk of colorectal cancer (CRC) has not been adequately assessed in prospective epidemiological studies.
Methods
We evaluated the association of acid-suppressive medication use with CRC risk among 175,871 (PPI) and 208,831 (H2RA) participants from three large prospective cohort studies. Medication use was assessed at baseline and updated biennially. The association was evaluated using multivariate Cox proportional hazards regression models.
Results
There was no significant association between baseline PPI use (hazard ratio (HR) = 0.89, 95% confidence interval (CI), 0.71–1.12) or PPI use after a lag of 8–10 years (HR = 1.12, 95% CI, 0.78–1.59) with CRC risk. We observed no significant association between H2RA use after a lag of 8–10 years and CRC risk (HR = 1.02, 95% CI, 0.81–1.28), while risk was lower for participants with baseline H2RA use (HR = 0.76, 95% CI, 0.60–0.95). Duration of PPI use or H2RA use was not associated with CRC risk (P-trend = 0.21 and 0.95, respectively).
Conclusions
Among participants from three large prospective cohorts, use of PPI or H2RA was not associated with higher risk of colorectal cancer.
Funder
U.S. Department of Health & Human Services | National Institutes of Health
American Cancer Society
Crohn's and Colitis Foundation
Cancer Research UK
U.S. Department of Defense
Publisher
Springer Science and Business Media LLC
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