Korean J Prev Med.  2002 Aug;35(3):245-254.

H2 Receptor Antagonists and Gastric Cancer in the Elderly: A Nested Case-Control Study

• Kim Y
• Heo DS
• Lee SM
• Youn KE
• Koo HW
• Bae JM
• Park BJ

Abstract

OBJECTIVE
To test if the intake of H2 receptor antagonists (H2-RAs) increases the risk of gastric cancer in the elderly.
METHODS
The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1993. The information on H2-RAs exposure was obtained from a drug prescription database compiled between Jan. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model.
RESULTS
After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 (95% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80).
CONCLUSION
The intake of H2-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.

Keyword

H2 receptor antagonist; Gastric cancer; Elderly; Pharmacoepidemiology; KEPEC

MeSH Terms

Achlorhydria
Aged*
Body Mass Index
Busan
Case-Control Studies*
Cimetidine
Cohort Studies
Drug Prescriptions
Famotidine
Follow-Up Studies
Humans
Insurance
Korea
Logistic Models
Odds Ratio
Parturition
Pharmacoepidemiology
Postal Service
Surveys and Questionnaires
Ranitidine
Stomach Neoplasms*
Stomach Ulcer
Cimetidine
Famotidine
Ranitidine