Auburn ADED 7950 - 737128 (10 pages)

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737128



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737128

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Pages:
10
School:
Auburn University Main Campus
Course:
Aded 7950 - Dissertation Seminar

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Rapid 12484662 CROSS REF ID 737128 LENDER MDU Health Sciences Library BORROWER AAA Main Library TYPE Article CC CCG JOURNAL TITLE Gut USER JOURNAL TITLE Gut ARTICLE TITLE Long term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori a population based study ARTICLE AUTHOR Cheung Ka Shing VOLUME ISSUE MONTH 10 YEAR 2017 PAGES gutjnl ISSN 0017 5749 OCLC Processed by RapidX 11 3 2017 5 47 50 AM This material may be protected by copyright law Title 17 U S Code Downloaded from http gut bmj com on November 3 2017 Published by group bmj com Gut Online First published on October 31 2017 as 10 1136 gutjnl 2017 314605 GI cancer Original Article Long term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori a population based study Ka Shing Cheung 1 Esther W Chan 2 Angel Y S Wong 2 Lijia Chen 1 Ian C K Wong 2 3 Wai Keung Leung1 1 Department of Medicine The University of Hong Kong Queen Mary Hospital Hong Kong 2 Department of Pharmacology and Pharmacy Centre for Safe Medication Practice and Research The University of Hong Kong Hong Kong 3 UCL School of Pharmacy University College London London UK Correspondence to Dr Wai Keung Leung Department of Medicine Queen Mary Hospital 102 Pokfulam Road Hong Kong waikleung hku h k Received 1 June 2017 Revised 27 August 2017 Accepted 4 September 2017 Abstract Objective Proton pump inhibitors PPIs is associated with worsening of gastric atrophy particularly in Helicobacter pylori HP infected subjects We determined the association between PPIs use and gastric cancer GC among HP infected subjects who had received HP therapy Designs This study was based on a territory wide health database of Hong Kong We identified adults who had received an outpatient prescription of clarithromycinbased triple therapy between year 2003 and 2012 Patients who failed this regimen and those diagnosed to have GC within 12 months after HP therapy or gastric ulcer after therapy were excluded Prescriptions of PPIs or histamine 2 receptor antagonists H2RA started within 6 months before GC were excluded to avoid protopathic bias We evaluated GC risk with PPIs by Cox proportional hazards model with propensity score adjustment H2RA was used as a negative control exposure Result Among the 63 397 eligible subjects 153 0 24 developed GC during a median follow up of 7 6 years PPIs use was associated with an increased GC risk HR 2 44 95 CI 1 42 to 4 20 while H2RA was not HR 0 72 95 CI 0 48 to 1 07 The risk increased with duration of PPIs use HR 5 04 95 CI 1 23 to 20 61 6 65 95 CI 1 62 to 27 26 and 8 34 95 CI 2 02 to 34 41 for 1 year 2 years and 3 years respectively The adjusted absolute risk difference for PPIs versus nonPPIs use was 4 29 excess GC 95 CI



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