Bile Acid Sequestrant Use and Gastric Cancer: A National Retrospective Cohort Analysis

Area of Science:

• Gastroenterology
• Oncology
• Pharmacology

Background:

• Bile acids are linked to gastric carcinogenesis.
• The potential role of bile acid sequestrant medications (BAMs) in preventing gastric cancer (GC) is under investigation.

Purpose of the Study:

• To investigate the association between bile acid sequestrant medication use and the incidence of gastric cancer.
• To explore if BAMs have a protective effect against cardia and noncardia gastric cancer.

Main Methods:

• A cohort of 417,239 veterans with Helicobacter pylori testing between 2000-2020 was analyzed.
• Exposure was defined by the number of BAM prescriptions filled in the 5 years prior to the index date.
• Incident GC and its anatomic subsite were primary outcomes, analyzed using Kaplan-Meier curves and Cox proportional hazards models.

Main Results:

• Individuals with 4 or more BAM fills had a numerically lower incidence of GC (aHR 0.71; 95% CI, 0.37-1.36) compared to unexposed individuals.
• The association between BAM use and GC incidence was consistent across different anatomic subsites.
• Confidence intervals for the observed association were wide, indicating uncertainty.

Conclusions:

• Bile acid sequestrant medications may offer a protective effect against both cardia and noncardia gastric cancer.
• Further research and external validation are required to confirm these preliminary findings.