ArticleCancer research communications2026
Association of Cumulative Proton Pump Inhibitor Use with Prostate Cancer Risk and Outcomes: A Population-Based Cohort Study.
Article in Cancer research communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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12 authors.
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Abstract
Proton pump inhibitor (PPI) use has been associated with increased prostate cancer risk in case-control and cohort studies of men with a negative prostate biopsy. We estimated the association of cumulative PPI use with prostate cancer diagnosis and outcomes in a biopsy-naïve cohort of men using provincewide-linked administrative data from Ontario, Canada, including men ≥66 years with no prior prostate cancer diagnosis, biopsy, or treatment and no PPI/histamine-2-blocker prescriptions within the year preceding study inclusion (January 2003-December 2018). The primary outcome was time to prostate cancer diagnosis. Associations were evaluated using univariable/multivariable logistic regression models with complementary log-log modeling. Median follow-up was 9.2 years (n = 559,425), and 30.2% had any PPI use during follow-up. Annual PPI use increased from 2.4% (2003) to 13.8% (2019). Cumulative PPI use was associated with lower prostate cancer diagnosis rates [hazard ratio (HR) for highest user quintile vs. nonusers: 0.75, 95% confidence interval (CI), 0.71-0.79]. Following adjustment for the frequency of general practitioner visits and prostate-specific antigen tests in the preceding 2 years, PPI use was no longer associated with prostate cancer diagnosis (HR, 0.99; 95% CI, 0.93-1.05). No association was observed between PPI use and rates of clinically significant or high-grade prostate cancer (HRs, 0.99 and 1.04, respectively). Cumulative PPI use was associated with up to 17% lower rates of a first androgen deprivation therapy prescription or bilateral orchiectomy. Cumulative PPI use was not associated with prostate cancer diagnosis rates, including clinically significant and high-grade prostate cancer. These findings do not support an independent association between PPI use and prostate cancer risk. SIGNIFICANCE: Among biopsy-naïve older men, cumulative PPI use was not associated with prostate cancer diagnosis, including clinically significant and high-grade disease, after adjusting for healthcare resource utilization. These findings challenge prior observational signals suggesting increased risk and indicate that detection bias likely explains earlier associations.
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