Consumption patterns of the frequently used drugs and their impact on the gastric cancer epidemiological indices in Ukraine, 2014-2021

Introduction
Gastric cancer remains one of the leading causes of cancer-related death. Many frequently used drugs (proton pump inhibitors (PPI), statins, metformin, and non-steroidal anti-inflammatory drugs (NSAID)) can play a role in the development of gastric cancer or attenuate Helicobacter pylori’s adhesion (cysteine derivatives).

Aim
To analyse the patterns and dynamics of consumption of PPIs, statins, metformin, NSAIDs and cysteine derivatives in Ukraine in comparison with global trends, and to explore their potential impact on the gastric cancer morbidity in Ukraine.

Material and methods
The consumption of PPIs, statins, metformin, NSAIDs, and cysteine derivatives (by mean of daily defined doses (DDDs)/100 000 habitants per year, 2014–2020) and gastric cancer epidemiological indices, such as the incidence rate (per 100 000 habitants per year, 2014–2021), main forms, and age prevalence, were estimated in Ukraine.

Results
Levels of PPI, statins, metformin, NSAID, and cysteine derivative consumption increased by 98.61% (p < 0.0001), 199.15% (p < 0.0001), 141.29% (p < 0.0001), 23.51% (p < 0.0001), and 42.06% (p < 0.0001), respectively, in 2020 compared to 2014 whereas the gastric cancer incidence rate decreased by 26.56% (p < 0.0001) in 2021 compared to 2014 in Ukraine.

Discussion
The gastric cancer incidence rate decreased, and its epidemiological structure was stable, in Ukraine between 2014 and 2021. The consumption of PPIs, statins, metformin, NSAIDs, and cysteine derivatives might play a complex role in the development of gastric cancer.
Conclusions: The trends of the gastric cancer incidence rate, its epidemiological structure, and the increased consumption of PPIs, statins, metformin, NSAIDs, and cysteine derivatives in Ukraine between 2014 and 2021 correspond to global trends. Statins, metformin, NSAIDs, and cysteine derivatives might lead to a decline in gastric cancer in the population despite the increased consumption of PPIs.