我们的目的是在全国范围内的大型队列中评估与长期使用质子泵抑制剂 (PPI) 相关的结直肠腺癌 (CRA) 风险。回顾性队列研究。这项研究是在国家层面进行的，涵盖瑞典全体人口这项研究利用瑞典国家登记处来确定2005年7月至2012年12月期间累积使用PPI≥180天的所有成年人，不包括随访时间少于1年的参与者。总共纳入了 754~118 名维持性 PPI 使用者，最长随访时间为 7.5 年。维持性 PPI 使用（累计≥180 天），与维持性组胺 2 受体拮抗剂 (H2RA) 的使用进行比较。主要结局指标是 CRA 的风险，以标准化发病率 (SIR) 和 95% 置信区间 (CI) 表示。进行亚组分析以探讨适应症、肿瘤位置、肿瘤分期和随访持续时间的影响。拟合多变量泊松回归模型来估计 PPI 与 H2RA 使用的发病率比 (IRR) 和 95% CI。与一般人群相比，维持 PPI 使用者的 CRA 风险略有升高（SIR 1.10，95% CI=1.06）至 1.13），适用于男性和女性。 18-39岁（SIR 2.79，95% CI=1.62至4.47）和40-49岁（SIR 2.02，95% CI=1.65至2.45）的个体的风险显着高于一般人群。与一般人群相比，右侧 CRA 显示出更高的风险（SIR 1.26，95% CI=1.20 至 1.32）。维持性 PPI 使用者和维持性 H2RA 使用者之间的 CRA 风险没有显着差异（IRR 1.05，95% CI=0.87 至 1.27，p<0.05）。维持性 PPI 使用可能与 CRA 风险增加相关，但需要延长观察时间。© 作者（或其雇主）2024。根据 CC BY-NC 允许重复使用。禁止商业再利用。请参阅权利和权限。英国医学杂志出版。

We aimed to evaluate the risk of colorectal adenocarcinoma (CRA) associated with long-term use of proton pump inhibitors (PPIs) in a large nationwide cohort.Retrospective cohort study.This research was conducted at the national level, encompassing the entire population of Sweden.This study utilised Swedish national registries to identify all adults who had ≥180 days of cumulative PPI use between July 2005 and December 2012, excluding participants who were followed up for less than 1 year. A total of 754 118 maintenance PPI users were included, with a maximum follow-up of 7.5 years.Maintenance PPI use (cumulative≥180 days), with a comparator of maintenance histamine-2 receptor antagonist (H2RA) use.The primary outcome measure was the risk of CRA, presented as standardised incidence ratios (SIRs) with 95% confidence intervals (CIs). Subgroup analyses were performed to explore the impact of indications, tumour locations, tumour stages and the duration of follow-up. A multivariable Poisson regression model was fitted to estimate the incidence rate ratios (IRRs) and 95% CIs of PPI versus H2RA use.Maintenance PPI users exhibited a slightly elevated risk of CRA compared to the general population (SIR 1.10, 95% CI=1.06 to 1.13) for both men and women. Individuals aged 18-39 (SIR 2.79, 95% CI=1.62 to 4.47) and 40-49 (SIR 2.02, 95% CI=1.65 to 2.45) had significantly higher risks than the general population. Right-sided CRA showed a higher risk compared to the general population (SIR 1.26, 95% CI=1.20 to 1.32). There was no significant difference in the risk of CRA between maintenance PPI users and maintenance H2RA users (IRR 1.05, 95% CI=0.87 to 1.27, p<0.05).Maintenance PPI use may be associated with an increased risk of CRA, but a prolonged observation time is needed.© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.