Pd29-02 Association of Proton Pump Inhibitors Cumulative Use With Prostate Cancer Risk and Adverse Outcomes: A Population-Based Analysis

You have accessJournal of UrologyProstate Cancer: Epidemiology however, long-term, off-label use of PPIs continues to increase (6-10% of Americans). The objective of this study was to evaluate the association of cumulative PPI use with PCa diagnosis and adverse outcomes. METHODS: This is a population-based study, using provincewide-linked administrative data from Ontario including all men≥66 years with no prior PCa diagnosis, work-up, or treatment, and no PPI/H2-blocker prescriptions within the year preceding study inclusion (study period: January 2003 to December 2018). The primary exposure was cumulative PPI use, with H2-blockers as a positive control. Associations between study exposure and time-to-event outcomes were evaluated using multivariable complementary log-log logistic regression. RESULTS: The study cohort included 559,425 men (median follow-up: 10.1 years). Median age was 66 years. Any PPI use was observed in 26.1% of men. Annual PPI use increased from 0.9% to 15% between 2003 and 2019. On multivariable modeling, adjusted for age, income quintile and comorbidities, cumulative PPI exposure was associated with significantly increased rates of PCa diagnosis (HR=4.10, 95% CI:3.97-4.23). This association persisted following further adjustment for frequency of general practitioner visits and PSA testing (HR=2.87, p<0.001). Cumulative PPI exposure was also associated with increased rates of clinically significant (HR=4.42, 95% CI:4.11-4.75) and high-grade PCa (HR=3.78, 95% CI:3.37-4.24), time to first ADT prescription/bilateral orchiectomy (HR=2.93, 95% CI:2.77-3.09), and PSA doubling time≤6 months (HR=3.12, 95% CI:2.98-3.27). Compared to PPI use, the associations between H2-blocker use and study outcomes were of significantly lower magnitudes of effect. CONCLUSIONS: In a population-based cohort of elderly men, cumulative PPI intake was associated with clinically significant increases in the rates of PCa diagnosis, independent of PSA testing frequency and/or GP visits, as well as adverse PCa-related outcomes. In lieu of prospective data, these results should be used to counsel long-term PPI users regarding the long-term risks of adverse PCa outcomes. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e618 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Rashid K. Sayyid More articles by this author Raj Tiwari More articles by this author Bo Zhang More articles by this author Andrew Wilton More articles by this author Katherine Lajkosz More articles by this author Jessica Cockburn More articles by this author Rui Bernardino More articles by this author Zizo Al-Daqqaq More articles by this author Majed Al-Rumayyan More articles by this author Refik Saskin More articles by this author Neil E. Fleshner More articles by this author Expand All Advertisement PDF downloadLoading ...