Background/Objectives: Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders, but their potential association with lung cancer risk and mortality remains underexplored and debated. This study sought to investigate the association between PPI use and lung cancer likelihood and mortality, focusing on the impact of PPI exposure history and duration. Methods: This study utilized data from 6795 lung cancer patients, 27,180 matched controls, and 4257 deceased and 2538 surviving lung cancer patients from the Korean National Health Insurance Service’s Health Screening Cohort (2002–2019). Propensity score overlap weighting and logistic regression models were applied to assess the correlations between PPI usage history and duration with lung cancer risk and mortality, while standardized differences ensured balanced baseline characteristics. Results: Overall, PPI use was modestly associated, with a 19% increased likelihood of lung cancer occurrence (95% confidence intervals (CI): 1.12–1.26). Interestingly, prolonged PPI use (≥30 days) was linked to a 13% reduction in lung cancer incidence (95% CI: 0.80–0.94), particularly in subgroups such as older adults (≥70 years), individuals with gastroesophageal reflux disease (GERD) or hypertension, and those with low alcohol consumption. Conversely, overall PPI usage was linked with a 36% increased mortality likelihood among lung cancer patients (95% CI: 1.20–1.55), with prolonged use further correlating with a 27% higher mortality risk (95% CI: 1.05–1.53), especially in high-risk subgroups, including smokers, underweight individuals, and those with hypercholesterolemia or GERD. Conclusions: These findings may suggest a complex and context-dependent relationship between PPI use and lung cancer outcomes, emphasizing the need for individualized risk assessments and careful prescribing practices.
背景/目的：质子泵抑制剂（PPIs）广泛用于治疗酸相关胃肠道疾病，但其与肺癌风险和死亡率的潜在关联尚未得到充分探讨且存在争议。本研究旨在探讨PPI使用与肺癌发病及死亡率之间的关联，重点关注PPI用药史和用药时长的影响。方法：本研究利用韩国国民健康保险服务健康筛查队列（2002–2019年）中6795名肺癌患者、27180名匹配对照者，以及4257名已故和2538名存活的肺癌患者数据。采用倾向评分重叠加权法和逻辑回归模型评估PPI用药史及用药时长与肺癌风险及死亡率的相关性，并通过标准化差异确保基线特征的平衡。结果：总体而言，PPI使用与肺癌发生风险呈适度正相关，风险增加19%（95%置信区间（CI）：1.12–1.26）。有趣的是，长期使用PPI（≥30天）与肺癌发病率降低13%相关（95% CI：0.80–0.94），这一关联在老年人（≥70岁）、患有胃食管反流病（GERD）或高血压的个体以及低酒精摄入者等亚组中尤为明显。相反，总体PPI使用与肺癌患者死亡率增加36%相关（95% CI：1.20–1.55），而长期使用进一步与死亡率风险升高27%相关（95% CI：1.05–1.53），这一现象在吸烟者、体重过轻者以及患有高胆固醇血症或GERD的高风险亚组中更为突出。结论：这些发现可能提示PPI使用与肺癌结局之间存在复杂且情境依赖性的关系，强调了个体化风险评估和审慎处方实践的必要性。
肿瘤(癌症)患者之家