Study Questions Link Between Side Effects of Nexium, Prilosec and Stomach Cancer

Concerns over proton pump inhibitor (PPI) stomach cancer risks have circulated through the medical community since at least the 1980s, when the drugs were first approved.

Despite concerns in recent years, European researchers published a new study indicating they found no link between popular heartburn drugs like Nexium and Prilosec and an increased risk of stomach cancer.

The drugs belong to a class of medications known as proton pump inhibitors (PPIs), which are widely used to reduce stomach acid and to treat conditions like heartburn, ulcers and gastroesophageal reflux disease (GERD). They work by blocking the proton pumps in the stomach’s lining that produce acid, and are available in prescription and over-the-counter versions.

However, in 2017 researchers from Hong Kong published a study in the medical journal Gut, which suggested that the long-term use of proton pump inhibitors could increase the risk of gastric cancer after treatment for Helicobacter pylori infections. That same year, Swedish researchers found that maintenance use of PPIs was linked to triple the risk of gastric cancer when compared to their peers.

The new study, published in The BMJ on January 21, raises questions about those findings, following an examination of PPI use in five Nordic countries, including Denmark, Finland, Iceland, Norway and Sweden.

Led by Professor Jasper Lagergren, of the Karolinska Institutet and Karolinska University Hospital, researchers looked at all healthcare patients in the five Nordic countries from 1994 to 2000. They matched each patient with a gastric adenocarcinoma diagnosis with 10 control participants based on similar age, sex, year and country. The team then looked for evidence that linked the gastric cancer diagnoses with PPI use as well as use of histamine-2-receptor antagonists like Pepcid AC and Tagamet.

The researchers found 17,232 cases of gastric adenocarcinoma. However, according to the findings, there was no association between the use of drugs like Prilosec, Nexium and Prevacid, and an increased risk of stomach cancer.

In addition to finding no correlation between PPI use and stomach cancer, the researchers indicated they found several factors which may have led previous studies to the opposite conclusions.

“Multiple sources of error that led to a false positive association were identified—inclusion of proton pump inhibitor use shortly before the gastric adenocarcinoma diagnosis, short term use of proton pump inhibitors, cardia adenocarcinoma, and lack of adjustment for Helicobacter pylori related variables.”

– Professor Jasper Lagergren, Long term use of proton pump inhibitors and risk of stomach cancer: population based case-control study in five Nordic countries

The researchers concluded that despite fears which have circulated through the medical community since at least the 1980s,  “long term proton pump inhibitor use may not be associated with any increased risk of developing gastric non-cardia adenocarcinoma.”

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