Evidence map›Paper›PMID 41499053›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2026

Long-term use of potassium-competitive acid blockers and proton pump inhibitors and the risk of metachronous gastric cancer after H. pylori eradication: a multicenter cohort study.

Yasutoshi Shiratori, Yuntae Kim, Katsuyuki Fukuda, Nobumi Suzuki, Yoku Hayakawa, Yosuke Tsuji, Tsutomu Nishida, Shu Kiyotoki, Tetsuya Sumiyoshi, Kenkei Hasatani and 11 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Pepsinogen Assay Findings in Individuals With Gastric Atrophy and Intestinal Metaplasia.The Korean journal of helicobacter and upper gastrointestinal research · 2026
    Review
  2. Review
  3. Long-term acid suppression after gastric cancer treatment: clarifying denominators and time-dependent exposure.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
    Article
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors.

Yasutoshi ShiratoriDepartment of Gastroenterology, Maimonides Medical Center, New York, NY, USA. yshiratori@maimo.org.ORCID 0000-0002-7784-6210
Yuntae KimDepartment of Gastroenterology, St. Luke's International University, Tokyo, Japan.
Katsuyuki FukudaDepartment of Gastroenterology, St. Luke's International University, Tokyo, Japan.
Nobumi SuzukiDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Yoku HayakawaDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Yosuke TsujiDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Tsutomu NishidaDepartment of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka-Shi, Osaka, Japan.
Shu KiyotokiDepartment of Gastroenterology, Shuto General Hospital, Yanai-Shi, Yamaguchi, Japan.
Tetsuya SumiyoshiDepartment of Gastroenterology, Tonan Hospital, Sapporo-Shi, Hokkaido, Japan.
Kenkei HasataniDepartment of Gastroenterology, Fukui Prefectural Hospital, Fukui-Shi, Fukui, Japan.
Naohiro YoshidaDepartment of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa-Shi, Ishikawa, Japan.
Yasuhiko HamadaDepartment of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Mie, Japan.
Kazuhiro FurukawaDepartment of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Keiji OguraDepartment of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo, Japan.
Takuma OkamuraDepartment of Gastroenterology, Nagasaki Harbor Medical Center, Nagasaki, Japan.
Nobuo TodaDepartment of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan.
Masahiro AraiDepartment of Gastroenterology, Nerima Hikarigaoka Hospital, Nerima-Ku, Tokyo, Japan.
Susan HutflessDepartment of Gastrointestinal Epidemiology Research Center, Johns Hopkins University, Baltimore, MD, USA.
Neha SharmaDepartment of Gastroenterology, Maimonides Medical Center, New York, NY, USA.
Diana CheungDepartment of Gastroenterology, Maimonides Medical Center, New York, NY, USA.
Ryota NiikuraGastroenterological Endoscopy, Tokyo Medical University, Shinjuku-Ku, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsGastric cancer remains a significant health burden, especially in Asia. Potassium-competitive acid blockers (P-CABs) provide stronger acid suppression than proton pump inhibitors (PPIs), but their long-term impact on metachronous gastric cancer (MGC) remains unclear. This study evaluated the incidence and duration-dependent risk of MGC in P-CAB/PPI users.

methodsThis multicenter retrospective cohort study included patients from 15 institutions in Japan who underwent endoscopic or surgical resection for gastric cancer between 2014 and 2022. After exclusions, 7172 patients who had received H. pylori eradication were analyzed. Chronic use of P-CAB/PPI was defined as administration for more than 3 months. The primary outcome was the incidence of MGC. Cox regression models were used, along with subgroup analyses based on duration and initial treatment type (endoscopy versus surgery).

resultsDuring a median follow-up of 5.8 years, MGC developed in 342 patients. The incidence was highest among P-CAB users (20.9 per 1,000 person-years), followed by PPI users (13.5) and non-users (7.1). Both P-CAB and PPI use were independently associated with increased MGC risk (hazard ratio 3.89 and 1.75, respectively). The association between P-CAB use and MGC was stronger with longer durations of use (hazard ratio 3.44 for < 1 year, 3.95 for 1–3 years, and 9.36 for > 3 years) and was particularly evident in the post-endoscopic group (hazard ratio 4.22) in subgroup analyses.

conclusionsChronic use of P-CAB/PPI were associated with MGC. Longer duration may be associated with increased risk of MGC. Further studies are warranted to validate these findings.

Indexed as

Helicobacter InfectionsNeoplasms, Second PrimaryProton Pump InhibitorsStomach NeoplasmsAgedFemaleHelicobacter pyloriHumansIncidenceJapanMaleMiddle AgedRetrospective StudiesRisk FactorsProton Pump InhibitorsEndoscopyGastric acid suppressantsMetachronous cancersStomach neoplasms

Identifiers

PMID41499053

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.