People who take proton pump inhibitors (PPIs) for a long time to treat acid reflux or stomach ulcers may not need to worry about these drugs increasing their risk of stomach cancer.
This finding comes from a new study using health records from five Nordic countries, published in The BMJ.
For years, there has been concern that PPIs could raise the risk of stomach cancer. This fear dates back to the 1980s, and some recent studies have suggested that taking these medications might double the risk. However, those earlier studies had several flaws, such as not fully accounting for other health problems that could have influenced the results.
To address these concerns, a group of researchers designed a large and careful study using health care data from Denmark, Finland, Iceland, Norway, and Sweden. They examined records from a 26-year period, from 1994 to 2020. This gave them a large amount of high-quality information to work with.
The study included 17,232 people who had been diagnosed with stomach cancer. For each of these cases, the researchers selected 10 people of the same age and sex from the general population who did not have stomach cancer.
This added up to over 172,000 people in the control group. They compared the use of PPIs and another type of acid-reducing drug called histamine-2-receptor antagonists between the two groups.
Importantly, the researchers only looked at drug use that occurred more than one year before the cancer diagnosis or the study entry date. This was to avoid mistakenly linking recent drug use that could have been caused by early symptoms of cancer.
They also considered other factors that might affect the risk of stomach cancer.
These included whether a person had been treated for Helicobacter pylori (a bacteria linked to stomach cancer), had peptic ulcers, smoked, drank alcohol, had obesity or type 2 diabetes, or used certain medications. By adjusting for all of these variables, the researchers aimed to isolate the true impact of PPIs.
After analyzing the data, they found no link between long-term PPI use and an increased risk of stomach cancer. The same result applied to histamine-2-receptor antagonists.
While the study was observational—meaning it can’t prove cause and effect—it was well-designed and used detailed health records over a long period of time. The researchers acknowledge that some other factors, like diet or family history of stomach cancer, were not included in the analysis. Still, they believe the study overcame many of the weaknesses seen in past research.
The main conclusion is clear: the results do not support the idea that long-term use of PPIs causes stomach cancer. This should be comforting news for people who rely on these medications to manage ongoing stomach problems.
For doctors and patients, this study is important. It suggests that long-term PPI treatment can be safe in terms of cancer risk, and that patients who need these drugs don’t necessarily have to stop using them out of fear of developing stomach cancer.
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