{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:38:25Z","timestamp":1786977505974,"version":"build-2736575974"},"reference-count":57,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:00:00Z","timestamp":1611100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Despite\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (HP) eradication, individuals can still develop gastric cancer (GC). Prior studies have demonstrated that nonaspirin nonsteroidal anti\u2010inflammatory drugs (NA\u2010NSAIDs) reduce the risk of GC, but this may be caused by immortal time bias and failure to adjust for HP status. The objective of this study was to investigate whether NA\u2010NSAIDs reduced the risk of GC in patients who undergo\n                      <jats:italic>H. pylori<\/jats:italic>\n                      eradication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients who had received clarithromycin\u2010based triple therapy between 2003 and 2016 were identified from a territory\u2010wide health care database. Exclusion criteria included prior GC or GC diagnosed &lt;6 months after HP eradication, prior gastrectomy, gastric ulcer after HP eradication, and failure of triple therapy. Covariates included age, sex, prior peptic ulcer disease, other comorbidities, and concurrent medications (aspirin, proton pump inhibitors, statins, and metformin). To avoid immortal time bias, NA\u2010NSAID use (\u226590 days) was treated as a time\u2010dependent variable in a multivariable Cox model (time\u2010dependent analysis). Time\u2010independent analysis was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow\u2010up of 8.9 years (interquartile range, 5.4\u201012.6 years), 364 of 92,017 patients (0.4%) who underwent HP eradication developed GC. NA\u2010NSAID use was associated with a significant reduction in the risk of GC in time\u2010fixed analysis (adjusted hazard ratio [aHR], 0.65; 95% CI, 0.47\u20100.90), but not in time\u2010dependent multivariable analysis (aHR, 1.35; 95% CI, 0.97\u20101.87). Time\u2010dependent subgroup analyses also did not indicate any significant association between NA\u2010NSAID use and either cardia GC (aHR, 0.75; 95% CI, 0.27\u20102.06) or noncardia GC (aHR, 1.28; 95% CI, 0.83\u20101.98).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NA\u2010NSAID use was not associated with a reduced risk of GC among patients who underwent HP eradication. The chemopreventive effect of NA\u2010NSAIDs observed in prior studies may have been confounded by immortal time bias.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.33412","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T10:10:20Z","timestamp":1611137420000},"page":"1805-1815","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Nonaspirin nonsteroidal anti\u2010inflammatory drugs and gastric cancer risk after\n                    <i>Helicobacter pylori<\/i>\n                    eradication: A territory\u2010wide study"],"prefix":"10.1002","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8619-5210","authenticated-orcid":false,"given":"Bofei","family":"Li","sequence":"first","affiliation":[{"name":"Department of Surgery The University of Hong Kong Queen Mary Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-378X","authenticated-orcid":false,"given":"Ka Shing","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine The University of Hong Kong Queen Mary Hospital Hong Kong China"},{"name":"Department of Medicine The University of Hong Kong\u2010Shenzhen Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian Yu\u2010Hong","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong Queen Mary Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5993-1059","authenticated-orcid":false,"given":"Wai Keung","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Medicine The University of Hong Kong Queen Mary Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6518-5806","authenticated-orcid":false,"given":"Simon","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong Queen Mary Hospital Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28999"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.49.3.347"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.01.028"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v10.i5.115"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2013.08.016"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI30111"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2015.105"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15693"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.11.019"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0b013e328339648c"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djg106"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.26.0695"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314605"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djx267"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-1044"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djy144"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604880"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2015.210"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b5087"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.08.051"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-318352"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.pa.33.040193.002251"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.749135"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.04.022"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.563"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312288"},{"key":"e_1_2_8_29_1","unstructured":"The Hospital Authority.Hospital Authority Statistical Report 2015\u20102016. 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