The dose–response effect of proton pump inhibitors on colorectal cancer prognosis is still under exploration. This population-based study in Taiwan was designed to examine the effect of proton pump inhibitors on overall death, colorectal cancer-specific death, and recurrence in colorectal cancer patients with different cumulative proton pump inhibitor dose levels. This cohort study was based on the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database from 2005 to 2020. After frequency matching with a 1:1 ratio, a total of 20,889 users with proton pump inhibitors and 20,889 without proton pump inhibitors were analyzed. The cumulative defined daily dose level of proton pump inhibitor was stratified to explore the dose–response relationship. A proton pump inhibitor exposure cumulative defined daily dose > 60 after colorectal cancer diagnosis had higher risk of all-cause death than non-proton pump inhibitor users with adjusted hazard ratios of 1.10 (95% CIs: 1.04–1.18). For recurrence, a proton pump inhibitor exposure cumulative defined daily dose > 60 had reduced recurrence risk with an adjusted hazard ratio of 0.84 (95% CIs: 0.76–0.93). This study demonstrated that the long-term use of proton pump inhibitors in patients with colorectal cancer was associated with an increased risk of death that related to the proton pump inhibitor exposure cumulative defined daily dose > 60 and had different dose–response effect in various dose level.
质子泵抑制剂对结直肠癌预后的剂量-效应关系仍有待探索。这项基于台湾地区人群的研究旨在探讨不同累积剂量质子泵抑制剂对结直肠癌患者全因死亡、结直肠癌特异性死亡及复发风险的影响。本队列研究基于2005年至2020年台湾癌症登记数据库与全民健康保险研究资料库，经1:1频率匹配后，共纳入20,889例质子泵抑制剂使用者和20,889例非使用者进行分析。研究通过分层质子泵抑制剂累积限定日剂量水平探讨剂量-效应关系。结果显示，结直肠癌诊断后质子泵抑制剂累积限定日剂量>60的患者，其全因死亡风险较非使用者显著升高（校正风险比1.10，95%置信区间1.04-1.18）。在复发风险方面，质子泵抑制剂累积限定日剂量>60的患者复发风险反而降低（校正风险比0.84，95%置信区间0.76-0.93）。本研究证实，结直肠癌患者长期使用质子泵抑制剂与死亡风险增加相关，该效应与累积限定日剂量>60存在关联，且在不同剂量水平呈现差异化的剂量-效应关系。
肿瘤(癌症)患者之家