Pharmacoepidemiological Research on N-Nitrosodimethylamine-Contaminated Ranitidine Use and Long-Term Cancer Risk: A Population-Based Longitudinal Cohort Study.

Content Provider	Europe PMC
Author	Wang, Chun-Hsiang Chen, I-I Chen, Chung-Hung Tseng, Yuan-Tsung
Editor	Tchounwou, Paul B.
Copyright Year	2022
Abstract	N-Nitrosodimethylamine (NDMA), a carcinogenic chemical, has recently been identified in ranitidine. We conducted a population-based study to explore ranitidine use and cancer emergence over time. Using the Taiwan National Health Insurance Research Database, a population-based cohort study was conducted. A total of 55,110 eligible patients who received ranitidine between January 2000 and December 2018 were enrolled in the treated cohort. We conducted a 1:1 propensity-score-matching procedure to match the ranitidine-treated group with the ranitidine-untreated group and famotidine controls for a longitudinal study. The association of ranitidine exposure with cancer outcomes was assessed. A multivariable Cox regression analysis that compared cancer risk with the untreated groups revealed that ranitidine increased the risk of liver (hazard ratio (HR): 1.22, 95% confidence interval (CI): 1.09-1.36, p < 0.001), lung (HR: 1.17, CI: 1.05-1.31, p = 0.005), gastric (HR: 1.26, CI: 1.05-1.52, p = 0.012), and pancreatic cancers (HR 1.35, CI: 1.03-1.77, p = 0.030). Our real-world observational study strongly supports the pathogenic role of NDMA contamination, given that long-term ranitidine use is associated with a higher likelihood of liver cancer development in ranitidine users compared with the control groups of non-ranitidine users treated with famotidine or proton-pump inhibitors.
ISSN	16617827
Journal	International Journal of Environmental Research and Public Health [Int J Environ Res Public Health]
Volume Number	19
DOI	10.3390/ijerph191912469
PubMed Central reference number	PMC9566239
Issue Number	19
PubMed reference number	36231768
e-ISSN	16604601
Language	English
Publisher	Molecular Diversity Preservation International (MDPI)
Publisher Date	2022-09-30
Access Restriction	Open
Subject Keyword	ranitidine famotidine cancers N-nitrosodimethylamine (NDMA) propensity score matching (PSM)
Content Type	Text
Resource Type	Case study
Subject	Health, Toxicology and Mutagenesis Pollution Public Health, Environmental and Occupational Health