Korean J Fam Med.  2012 Sep;33(5):272-279. 10.4082/kjfm.2012.33.5.272.

Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies

Affiliations
  • 1Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
  • 3Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 4Carcinogenesis Research Branch, Research Institute, National Cancer Center, Goyang, Korea. msk@ncc.re.kr
  • 5Family Medicine Clinic, National Cancer Center Hospital, National Cancer Center, Goyang, Korea.

Abstract

BACKGROUND
Previous case-control studies have reported inconsistent findings regarding the association between proton pump inhibitor (PPI) use and colorectal cancer (CRC) risk. We investigated these associations using meta-analysis.
METHODS
We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library in April 2011. Two evaluators independently reviewed and selected articles, based on pre-determined selection criteria.
RESULTS
Out of 737 articles meeting our initial criteria, 5 case-control studies, which involved 120,091 participants (9,514 cases and 110,577 controls), were included in the final analyses. The overall use of PPI (used vs. never or rarely used) was not significantly associated with the risk of CRC in a fixed-effects model meta-analysis of all 5 case-control studies (odds ratio [OR], 1.08; 95% confidence interval [CI], 0.96 to 1.20; I2 = 3.5%). Also, in sensitivity meta-analysis by cumulative duration of PPI use, there was no association between PPI use of 1 year or longer and the risk of colorectal cancer in a fixed-effects meta-analysis (OR, 1.09; 95% CI, 0.98 to 1.22; I2 = 0%).
CONCLUSION
Although hypergastrinemia could be an important factor in the pathogenesis of some colorectal cancers, our study suggests that this does not lead to significant clinical risk for most PPI users. Further prospective studies or randomized controlled trials related to PPI use and colorectal cancer risk are needed to investigate this association.

Keyword

Proton Pump Inhibitors; Colorectal Neoplasms; Meta-analysis

MeSH Terms

Case-Control Studies
Colorectal Neoplasms
Proton Pump Inhibitors
Proton Pumps
Protons
Proton Pump Inhibitors
Proton Pumps
Protons
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