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Thus, we aimed to evaluate such association within the Stomach cancer Pooling (StoP) Project.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data from five case\u2013control studies of the StoP Project were included (1,889 cases and 6,517 controls). We assessed the impact of different exposure definitions, specifically any reported use of PPIs and exposure definitions based on the duration of PPI intake. Additionally, we modeled the dose\u2013response relationship between the cumulative duration of PPI intake and gastric cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Significant associations between PPI intake and gastric cancer, both overall and in the stratified analyses, were limited to exposure definitions based on short durations of intake. The overall odds ratio (OR) for any reported PPI intake was 1.78 [95% confidence interval (CI): 0.76\u20134.14]. In the dose\u2013response analysis, the ORs of gastric cancer were found to be higher for short durations of PPI intake (6 months: OR 3.26; 95% CI: 2.40\u20134.42; one year: OR 2.14; 95% CI: 1.69\u20132.70; 2 years: OR 1.50; 95% CI: 1.22\u20131.85; 3 years: OR 1.27; 95% CI: 1.03\u20131.56), with the association becoming not significant for durations longer than 3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our findings suggest that the observed association between PPIs and gastric cancer might be mainly due to reverse causality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact:<\/jats:title>\n                    <jats:p>The results of this study suggest that PPIs are a safe therapeutic choice regarding their effect on the occurrence of gastric cancer.<\/jats:p>\n                    <jats:p>See related commentary by Richman and Leiman, p. 1127<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1158\/1055-9965.epi-23-0241","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T14:45:36Z","timestamp":1687790736000},"page":"1174-1181","update-policy":"https:\/\/doi.org\/10.1158\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Intake of Proton-Pump Inhibitors and Gastric Cancer within the Stomach Cancer Pooling (StoP) Project"],"prefix":"10.1158","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3158-1827","authenticated-orcid":false,"given":"Michele","family":"Sassano","sequence":"first","affiliation":[{"name":"1Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy."},{"name":"2Section of Hygiene, University Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy."}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7799-4291","authenticated-orcid":false,"given":"Marco","family":"Mariani","sequence":"additional","affiliation":[{"name":"2Section of Hygiene, University Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy."}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1425-8945","authenticated-orcid":false,"given":"Claudio","family":"Pelucchi","sequence":"additional","affiliation":[{"name":"3Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy."}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1870-1430","authenticated-orcid":false,"given":"Nuno","family":"Lunet","sequence":"additional","affiliation":[{"name":"4EPIUnit - Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Porto, Portugal."},{"name":"5Laborat\u00f3rio para a Investiga\u00e7\u00e3o Integrativa e Translacional em Sa\u00fade Populacional (ITR), Porto, Portugal."},{"name":"6Departamento de Ci\u00eancias da Sa\u00fade P\u00fablica e Forenses e Educa\u00e7\u00e3o M\u00e9dica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal."}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5808-0179","authenticated-orcid":false,"given":"Samantha","family":"Morais","sequence":"additional","affiliation":[{"name":"4EPIUnit - Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Porto, Portugal."},{"name":"5Laborat\u00f3rio para a Investiga\u00e7\u00e3o Integrativa e Translacional em Sa\u00fade Populacional (ITR), Porto, Portugal."},{"name":"6Departamento de Ci\u00eancias da Sa\u00fade P\u00fablica e Forenses e Educa\u00e7\u00e3o M\u00e9dica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal."}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0552-2804","authenticated-orcid":false,"given":"Vicente","family":"Mart\u00edn","sequence":"additional","affiliation":[{"name":"7Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de Le\u00f3n, Le\u00f3n, Spain."},{"name":"8Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain."}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2818-5487","authenticated-orcid":false,"given":"Victor","family":"Moreno","sequence":"additional","affiliation":[{"name":"8Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain."},{"name":"9Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), Barcelona, Spain."},{"name":"10Colorectal Cancer Group, ONCOBELL Program, Institut de Recerca Biomedica de Bellvitge (IDIBELL), Barcelona, Spain."},{"name":"11Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain."}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8172-2483","authenticated-orcid":false,"given":"Maria Paula","family":"Curado","sequence":"additional","affiliation":[{"name":"12Centro Internacional de Pesquisa, A. 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