stomach and small intestines

Selected drugs (known as proton pump inhibitors) used to reduce stomach acid may double the risk of the development of stomach cancer. Still, we need more data, and the study showing this relationship conflicts with previously published research.

Proton-pump inhibitors (PPIs) are a group of drugs whose main action is a pronounced and long-lasting reduction of stomach acid production. Selected examples include the following: Omeprazole, lansoprazole, dexlansoprazole, esomeprazole, and pantoprazole. A recent study from Hong Kong published online October 31, 2017 in the journal Gut suggests a clear dose-response and time-response trend for the use of these drugs and stomach (gastric) cancer.

I think we need more data before reaching a conclusion. Indeed, this study was an observational one that cannot establish cause and effect. In addition, these results conflict with a recently published study with pantoprazole, finding no increase in the risk for stomach cancer (with prolonged exposure to the proton pump inhibitor). In addition, it is not clear that the results will hold across geographies. In addition, the researchers  lacked information on some risk factors, such as diet, family history, and socioeconomic status.  And despite the large sample of more than 63,000 H pylori–infected patients, the small number of gastric cancer cases did not allow for any meaningful evaluation of the dosage effect and role of different proton pump inhibitor drugs. I’m Dr. Michael Hunter.


Dr. Michael Hunter