Table 3.
The association between H2RA use and the risk of gastric cancer in the PCCIU database.
| Unadjusted | Adjusteda | Fully adjustedb | |||
|---|---|---|---|---|---|
| Case, n (%) | Control, n (%) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
| H2RA main analysis (removing 1 year before the index) | |||||
| H2RA user vs. non-user | 199/1119 (17.8) | 689/5394 (12.8) | 1.49 (1.25, 1.77) | 1.49 (1.24, 1.78) | 1.44 (1.16, 1.80) |
| Male only | 100/639 (15.6) | 356/3082 (11.6) | 1.42 (1.11, 1.82) | 1.41 (1.10, 1.81) | 1.43 (1.05, 1.94) |
| Female only | 99/480 (20.6) | 333/2312 (14.4) | 1.56 (1.21, 2.01) | 1.57 (1.21, 2.04) | 1.45 (1.04, 2.01) |
| Dose–response analysis (removing 1 year before the index) | |||||
| 1–183 DDDs vs. non-user | 107/1119 (9.6) | 370/5394 (6.9) | 1.49 (1.18, 1.87) | 1.49 (1.18, 1.88) | 1.40 (1.05, 1.85) |
| 184–365 DDDs vs. non-user | 22/1119 (2.0) | 76/5394 (1.4) | 1.50 (0.93, 2.41) | 1.49 (0.92, 2.40) | 1.42 (0.77, 2.60) |
| 366–1095 DDDs vs. non-user | 51/1119 (4.6) | 172/5394 (3.2) | 1.52 (1.10, 2.10) | 1.51 (1.09, 2.10) | 1.50 (0.99, 2.29) |
| ≥1096 DDDs vs. non-user | 19/1119 (1.7) | 71/5394 (1.3) | 1.38 (0.82, 2.33) | 1.37 (0.81, 2.32) | 1.62 (0.86, 3.05) |
| P value for the trend | <0.001 | <0.001 | 0.003 | ||
| 1–6 prescriptions vs. non-user | 105/1119 (9.4) | 375/5394 (6.9) | 1.44 (1.14, 1.81) | 1.44 (1.14, 1.82) | 1.38 (1.04, 1.83) |
| 6–12 prescriptions vs. non-user | 34/1119 (3.0) | 101/5394 (1.8) | 1.72 (1.16, 2.56) | 1.71 (1.15, 2.55) | 1.54 (0.93, 2.54) |
| 12–36 prescriptions vs. non-user | 46/1119 (4.1) | 163/5394 (3.0) | 1.46 (1.04, 2.05) | 1.45 (1.03, 2.05) | 1.58 (1.03, 2.42) |
| ≥36 prescriptions vs. non-user | 14/1119 (1.3) | 50/5394 (0.9) | 1.44 (0.79, 2.63) | 1.44 (0.79, 2.64) | 1.34 (0.62, 2.90) |
| P value for the trend | <0.001 | <0.001 | 0.003 | ||
| H2RA user vs. non-user when removing prescriptions in specific duration | |||||
| Removing 2 years before the index | 137/862 (15.9) | 518/4126 (12.6) | 1.32 (1.07, 1.63) | 1.30 (1.05, 1.61) | 1.32 (1.02, 1.70) |
| Removing 3 years before the index | 93/644 (14.4) | 386/3062 (12.6) | 1.16 (0.90, 1.50) | 1.15 (0.89, 1.48) | 1.16 (0.85, 1.57) |
| Removing 4 years before the index | 63/474 (13.3) | 284/2235 (12.7) | 1.03 (0.76, 1.39) | 1.01 (0.74, 1.37) | 1.06 (0.74, 1.52) |
| Removing 5 years before the index | 44/345 (12.8) | 199/1611 (12.4) | 1.00 (0.70, 1.43) | 0.99 (0.69, 1.43) | 1.13 (0.74, 1.72) |
| H2RA user in specific time periods before index date/cancer diagnosis date | |||||
| 0–1 y before indexc | 178/1119 (15.9) | 323/5394 (6.0) | 3.05 (2.49, 3.72) | 3.04 (2.48, 3.72) | 3.07 (2.37, 3.98) |
| 1–2 y before indexd | 114/1119 (10.2) | 329/5394 (6.1) | 1.77 (1.42, 2.22) | 1.78 (1.41, 2.23) | 1.87 (1.40, 2.50) |
| 2–3 y before indexe | 77/862 (8.9) | 263/4126 (6.4) | 1.46 (1.12, 1.91) | 1.45 (1.11, 1.91) | 1.55 (1.11, 2.16) |
| 3–4 y before indexf | 53/644 (8.4) | 196/3062 (6.4) | 1.32 (0.96, 1.83) | 1.33 (0.96, 1.85) | 1.26 (0.85, 1.87) |
| 4–5 y before indexg | 38/474 (8.0) | 136/2235 (6.1) | 1.35 (0.92, 1.98) | 1.34 (0.91, 1.97) | 1.29 (0.81, 2.05) |
| H2RA new user vs. H2RA non-new userh | 89/1119 (7.9) | 58/5394 (1.1) | 8.11 (5.75, 11.43) | 8.26 (5.85, 11.68) | 9.87 (6.04, 16.15) |
| Cimetidine user vs. non-user | |||||
| Removing 1 year before the index | 85/1119 (7.6) | 254/5394 (4.7) | 1.68 (1.30, 2.17) | 1.66 (1.28, 2.15) | 1.43 (1.02, 2.01) |
| Removing 2 years before the index | 62/862 (7.2) | 193/4126 (4.7) | 1.59 (1.18, 2.15) | 1.55 (1.14, 2.10) | 1.31 (0.90, 1.93) |
| Removing 3 years before the index | 39/644 (6.1) | 148/3062 (4.8) | 1.27 (0.88, 1.83) | 1.23 (0.85, 1.79) | 1.10 (0.70, 1.75) |
| Ranitidine user vs. non-user | |||||
| Removing 1 year before the index | 128/1119 (11.4) | 459/5394 (8.5) | 1.39 (1.12, 1.71) | 1.10 (0.94, 1.29) | 1.42 (1.10, 1.85) |
| Removing 2 years before the index | 78/862 (9.1) | 341/4126 (8.3) | 1.09 (0.84, 1.42) | 1.09 (0.84, 1.43) | 1.22 (0.89, 1.67) |
| Removing 3 years before the index | 57/644 (8.9) | 255/3062 (8.3) | 1.05 (0.77, 1.43) | 1.05 (0.77, 1.44) | 1.17 (0.81, 1.68) |
| Sensitivity analysis (H2RA user vs. non-user) | |||||
| Additionally adjusted for PPIi | 199/1119 (17.8) | 689/5394 (12.8) | 1.49 (1.25, 1.77) | 1.39 (1.16, 1.67) | 1.33 (1.07, 1.67) |
| H2RA user vs. PPI userj | 199/431 (46.2) | 689/1604 (43.0) | 1.03 (0.78, 1.36) | 1.00 (0.75, 1.33) | 0.86 (0.60, 1.24) |
| Adjusted for lifestyle using multiple imputationk | 199/1119 (17.8) | 689/5394 (12.8) | 1.49 (1.25, 1.77) | 1.49 (1.24, 1.78) | 1.45 (1.22, 1.75) |
| Additionally not adjusted for peptic ulcer and oesophagitisl | 199/1119 (17.8) | 689/5394 (12.8) | 1.49 (1.25, 1.77) | 1.47 (1.23, 1.76) | 1.42 (1.14, 1.77) |
aStudy matched on age, sex and general practice, and the model contains obesity, comorbidities in the exposure period (including diabetes, coronary heart disease, myocardial infarction, heart failure, peripheral vascular disease, cerebrovascular disease, cerebrovascular accident, chronic obstructive pulmonary disease, mental illness, liver disease, peptic ulcer and oesophagitis) and other medication uses in the exposure period (statins and aspirin).
bAdditionally adjusted for alcohol and smoking.
cMedication use in the year prior to diagnosis/index date restricted to individuals with at least 3 years of records.
dMedication use in the year from 2 to 1 year prior to diagnosis/index date restricted to individuals with at least 3 years of records.
eMedication use in the year from 3 to 2 years prior to diagnosis/index date restricted to individuals with at least 4 years of records.
fMedication use in the year from 4 to 3 years prior to diagnosis/index date restricted to individuals with at least 5 years of records.
gMedication use in the year from 5 to 4 years prior to diagnosis/index date restricted to individuals with at least 6 years of records.
hProportion of cases and controls who used H2RA in the year before diagnosis, and who had not previously used H2RA.
iAdditionally adjusted for PPI.
jUsing only PPI users as an active comparator.
kUsing multiple imputation to adjust for alcohol and smoking.
lRemoving the peptic ulcer and oesophagitis adjustment from the main model.