Proton Pump Inhibitor Use is Associated With Risk of Pancreatic Cancer: A Nested Case-Control Study

Yen-Chun Peng; Cheng-Li Lin; Wan-Yun Hsu; I-Ta Lu; Hong-Zen Yeh; Chi-Sen Chang; Chia-Hung Kao

doi:10.1177/1559325818803283

Proton Pump Inhibitor Use is Associated With Risk of Pancreatic Cancer: A Nested Case-Control Study

Dose Response. 2018 Oct 1;16(4):1559325818803283. doi: 10.1177/1559325818803283. eCollection 2018 Oct-Dec.

Authors

Yen-Chun Peng^{1

2}, Cheng-Li Lin^{3

4}, Wan-Yun Hsu⁵, I-Ta Lu¹, Hong-Zen Yeh^{1

2}, Chi-Sen Chang¹, Chia-Hung Kao^{6

7

8}

Affiliations

¹ Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
² National Yang-Ming University, Taipei, Taiwan.
³ China Medical University Hospital, Taichung, Taiwan.
⁴ College of Medicine, China Medical University, Taichung, Taiwan.
⁵ Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan.
⁶ Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
⁷ Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
⁸ Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.

Abstract

Purpose: To investigate the use of proton pump inhibitors (PPIs) and the risk of pancreatic cancer.

Methods: A nested case-control analysis was conducted. Patients with pancreas cancer were matched with controls by propensity score. Univariate and multivariate logistic regression models were used to determine whether PPIs use affected the risk of pancreas cancer. Dose effect was analyzed based on the cumulative defined daily dose (DDD), which was calculated using the total supply of PPIs to individual patients in terms of days and quantity.

Results: A total of 1087 patients with pancreas cancer were matched with 1087 control patients from the database. The overall adjusted odds ratio (OR) of PPI use associated with pancreas cancer was 1.69 (95% confidence interval [CI], 1.44-2.05). Dose analysis by cumulative DDD, based on all types of PPI combined, revealed a lower adjusted OR of 0.92 (95% CI, 0.64-1.33) for those on <30 cumulative DDD compared with those on ≥150 cumulative DDD, whose adjusted OR was 2.19 (95% CI, 1.68-2.85). Compared with PPI nonusers, the risks of pancreas cancer were: OR 0.89 (95% CI, 0.62-1.27) for patients using PPI <30 days and 2.22 (95% CI, 1.68-2.94) for ≥150 days.

Conclusions: Risk of pancreas cancer was associated with PPI use in patients with peptic ulcer diseases or gastroesophageal reflux disease.

Keywords: National Health Insurance Research database; nested case–control; pancreas cancer; population-based; proton pump inhibitors.