Title

Proton Pump Inhibitors Do Not Increase the Risk of Colorectal Cancer
May 26, 2021

By Eric Ramos

VIRTUAL -- May 26, 2021 -- A systematic review and meta-analysis that included over 1 million proton pump inhibitor (PPI) users, presented at Digestive Disease Week (DDW) 2021, found no association between PPI use and colorectal cancer risk.

“Long-term PPI use has raised concerns about potential adverse effects and possible risks of associated hypergastrinemia, including risk of GI cancers,” said Faisal Kamal, MD, University of Tennessee Health Sciences Center, Memphis, Tennessee. “We found no significant increase in the rate of colorectal cancer, even with more than 5 years of continuous PPI use.”

The researchers searched Pubmed, Embase, Scopus, Web of Science, and the Cochrane library from inception to November 2020 for observational studies evaluating the association between PPI use and colorectal cancer. They included studies that reported summary results as adjusted odds ratio (OR) or hazard ratio (HR).

Included in the analysis were 10 observational studies with 1,036,974 patients. For the 7 case-control studies, the pooled OR was 1.22 (95% confidence interval [CI], 0.83-1.81; I2 = 97%). For the 3 cohort studies, the pooled HR was 1.21 (95% CI, 0.74-1.96; I2 = 91%).

The researchers also performed subgroup analysis of studies that reported data on rate of CRC with >5 years of continuous PPI use and found no significant increase in the rate of colorectal cancer (pooled OR = 1.09; 95% CI, 0.91-1.32; I2 = 0%.

The researchers noted that they encountered substantial heterogeneity in data and that the quality of evidence was very low based on GRADE framework. However, Funnel plots and Egger’s test did not show evidence of publication bias.

Digestive Disease Week is cosponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).

[Presentation title: Proton Pump Inhibitors Do Not Increase the Risk of Colorectal Cancer: Systematic Review and Meta-Analysis. Abstract Su069]