A healthy living blog from Marshfield Clinic

Proton pump inhibitors: Do they cause cancer?

Man eating takeout lunch - Heartburn drugs and cancer risk: Proton pump inhibitors

Research suggests proton pump inhibitors, a type of antacid, could lead to stomach cancer, but some doctors question the study.

Antacids are an important treatment option for those with acid reflux. However, research in 2017 suggested that a type of antacid called proton pump inhibitors could lead to stomach cancer.

“This study does not prove that proton pump inhibitors cause increased risk of stomach cancer,” said Dr. Sueyi Lai, oncologist with Marshfield Clinic Health System. “It suggests an associated increased risk, but it is just a link that needs to be looked at further.”

Doctors typically use proton pump inhibitors, such as Prilosec or Prevacid, and two antibiotics to treat acid reflux. They can also use H2 blockers, such as Pepcid and Tagamet, as an antacid.

A bacterial infection called H. pylori in the stomach is what typically causes acid reflux.

This bacterial infection also can cause gastritis, gastric ulcers and stomach cancer. If untreated, the risk for stomach cancer and other complications grows.

“The study shows there is a very tiny risk in a subgroup of patients that are already at an increased risk for stomach cancer,” said Lai.

Understanding the research

The study observed East-Asian populations that took proton pump inhibitors and H2 blockers for acid reflux caused by H. pylori for more than seven years.

“What they found is that patients on proton pump inhibitors seemed to have an increased risk of stomach cancer compared to those that are on H2 blockers,” Lai said.

Lai also said there were many issues with the study. For instance, East-Asian populations and those with H. pylori are already at a higher risk of getting stomach cancer.

It also was an observational study instead of a randomized controlled trial that leads to the best results, and the research did not account for other risk factors such as alcohol abuse, obesity, family history or smoking.

A lot of the experts in the gastrointestinal cancer field have explicitly stated that we need to use caution when we draw conclusions from this, and a lot of data actually supports otherwise,” Lai said.

According to the study, the risk for developing stomach cancer from proton pump inhibitors is small. It is less than one percent, or 0.24 percent. Lai said this is a lower percent than not treating the acid reflux that also causes stomach cancer.

While all medications have side effects, Lai said medications should only be used as clinically indicated and when necessary. If you have concerns about your risk for cancer when taking proton pump inhibitors, please talk with your doctor.

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