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Long-term PPI Use Tied to Doubled Risk for Gastric Cancer

 Use of a proton-pump inhibitor (PPI) after Helicobacter pylori eradication more than doubles the risk for gastric cancer, according to a population-based study from Hong Kong.

The “clear dose-response and time-response” trend in PPI use and gastric cancer risk observed suggests the need for “caution when prescribing long-term PPIs to these patients even after successful eradication of H. pylori,” write Wai Keung Leung, MBChB, MD, from Queen Mary Hospital, Hong Kong, and colleagues.

The study was published online October 31 in Gut.

The researchers point out, however, that this was an observational study, which can’t prove cause and effect.

The new results also conflict with a recently published, US Food and Drug Administration–mandated follow-up study conducted with pantoprazole, said David A. Johnson, MD, chief of gastroenterology at Eastern Virginia Medical School in Norfolk (Aliment Pharmacol Ther2016;43:73-82).

“No increased risk [for gastric cancer] was observed with prolonged PPI exposure,” he said.

Dr Johnson, who was asked for comment, also stated that the study has a “geographic bias” because it is from Hong Kong and “specific risks for gastric cancer are well recognized in Asian patients.”

In the new study, Dr Leung and colleagues partly focused on H pylori infection and its relationship with gastric cancer.

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