Table 3. Risk of PPI exposure for pancreatic cancer (case) development among various risk groups (reference: PPI non-user).
| <60 DDDs | ≥60 DDDs | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of cases | Person-years/105 | HR* | 95% CI | HR* | 95% CI | Pheterogeneity† | |||||
| Shifting the index, year | |||||||||||
| 2006 | 3,537 | 33.7 | 1.10 | 0.97 | 1.25 | 1.44 | 1.05 | 1.98 | 0.122 | ||
| 2007 (main) | 3,086 | 29.2 | 1.00 | 0.89 | 1.13 | 1.32 | 1.03 | 1.70 | 0.050 | ||
| 2008 | 2,625 | 24.7 | 1.02 | 0.91 | 1.14 | 1.01 | 0.90 | 1.13 | 0.904 | ||
| Extending the exclusion period | |||||||||||
| 1 year (main) | 3,086 | 29.2 | 1.00 | 0.89 | 1.13 | 1.32 | 1.03 | 1.70 | 0.050 | ||
| 2 years | 2,155 | 29.2 | 1.01 | 0.87 | 1.16 | 1.36 | 1.00 | 1.84 | 0.084 | ||
| Types of pancreatic cancer | |||||||||||
| All (main) | 3,086 | 29.2 | 1.00 | 0.89 | 1.13 | 1.32 | 1.03 | 1.70 | 0.050 | ||
| Exocrine only | 3,035 | 29.2 | 1.00 | 0.88 | 1.12 | 1.30 | 1.00 | 1.68 | 0.072 | ||
| Endocrine only | 51 | 29.2 | 1.19 | 0.50 | 2.83 | 2.79 | 0.67 | 11.70 | 0.318 | ||
| Subgroup effect | |||||||||||
| Age, years | |||||||||||
| 40–49 | 761 | 14.6 | 0.94 | 0.74 | 1.21 | 1.55 | 0.89 | 2.69 | 0.105 | ||
| ≥50 | 2,325 | 14.6 | 1.01 | 0.88 | 1.16 | 1.27 | 0.96 | 1.69 | 0.154 | ||
| Sex | |||||||||||
| Female | 1,266 | 13.8 | 1.08 | 0.90 | 1.29 | 1.68 | 1.16 | 2.44 | 0.036 | ||
| Male | 1,820 | 15.4 | 0.95 | 0.81 | 1.11 | 1.11 | 0.79 | 1.57 | 0.419 | ||
| Smoking status | |||||||||||
| Never | 2,039 | 20.4 | 1.00 | 0.86 | 1.15 | 1.47 | 1.09 | 1.98 | 0.023 | ||
| Former or Current | 1,000 | 8.5 | 1.01 | 0.82 | 1.24 | 1.05 | 0.65 | 1.70 | 0.884 | ||
| Alcohol, drinks/week | |||||||||||
| <1 | 2,167 | 21.2 | 0.99 | 0.86 | 1.14 | 1.50 | 1.13 | 1.98 | 0.009 | ||
| ≥1 | 897 | 7.8 | 1.02 | 0.82 | 1.27 | 0.89 | 0.50 | 1.58 | 0.664 | ||
| Type 2 diabetes | |||||||||||
| No | 2,520 | 26.2 | 0.97 | 0.86 | 1.11 | 1.38 | 1.06 | 1.80 | 0.019 | ||
| Yes | 566 | 3.0 | 1.21 | 0.86 | 1.70 | 0.98 | 0.43 | 2.20 | 0.640 | ||
| Chronic pancreatitis | |||||||||||
| No | 3,043 | 29.1 | 1.00 | 0.89 | 1.13 | 1.30 | 1.00 | 1.69 | 0.074 | ||
| Yes | 43 | 0.07 | — | — | — | — | — | — | — | ||
| CCI score | |||||||||||
| 0–1 | 1,551 | 18.1 | 0.97 | 0.78 | 1.20 | 1.23 | 0.71 | 2.13 | 0.430 | ||
| ≥2 | 1,535 | 11.1 | 1.01 | 0.87 | 1.16 | 1.35 | 1.01 | 1.79 | 0.076 | ||
PPI, proton pump inhibitor; DDD, Defined Daily Dose; HR, hazard ratio; CI, confidence interval; BMI, body mass index; CCI, Charlson Comorbidity Index.
*Using Cox proportional hazards regression models with adjustment for all potential confounders listed in Table 2.
†Using a χ2 test for heterogeneity between log HR and CIs of <60 DDD and ≥60 DDD groups.