Health

Long-Term PPI Use & Stomach Cancer Risk: New Study Findings

by Chief Editor
written by Chief Editor

Published On 24/1/2026

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Last Updated: 16:30 (Makkah Time)

For years, long-term use of acid-reducing medications like proton pump inhibitors (PPIs) has raised concerns about a potential link to an increased risk of
stomach cancer.
However, a large population-based study published in the British Medical Journal (BMJ) offers a more nuanced picture, suggesting this association may not exist when confounding factors and methodology are properly addressed.

The
study,
which analyzed national health data from five Northern European countries, concluded that long-term use of PPIs is not associated with an increased risk of stomach adenocarcinoma.

The research aimed to address methodological shortcomings in previous studies linking these drugs to stomach cancer, such as short follow-up periods, limited statistical power, accounting for medication use *before* cancer diagnosis, and failing to adjust for key factors like Helicobacter pylori infection.

Recognizing the difficulty of conducting long-term, randomized controlled trials in this field, researchers employed a robust observational design that accounted for these limitations.

The study, covering the period from 1994 to 2020 (16 years) within the “NordGETS” research project, utilized high-quality, complete national registries across five Scandinavian countries – Denmark, Finland, Iceland, Norway, and Sweden – and included:

  • 17,232 cases of stomach cancer.
  • 172,297 individuals without stomach cancer, randomly selected from the general population, matched for age, sex, year, and country.

<h2 id="drug-use" class="heading-with-anchor">
  Drug Use
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</h2>
<p>
  The study focused on long-term (over one year) use of PPIs, excluding the year prior to cancer diagnosis to avoid confounding the association between drug use and early, undiagnosed symptoms of the disease.
</p>
<p>
  A parallel analysis was also conducted on users of histamine-2 receptor antagonists – medications used for similar purposes – to test the specificity of the findings related to PPIs, reinforcing the reliability of the results.
</p>
<p>
  <strong>The results showed:</strong> 10.2% of stomach cancer cases had used PPIs long-term compared to 9.5% in the non-cancer group.
</p>
<p>
  After adjusting for multiple factors, including <i>H. pylori</i> infection, peptic ulcer disease, smoking, alcohol consumption, obesity, type 2 diabetes, and other medications, no statistically significant association was found between long-term PPI use and stomach cancer risk.
</p>
<p>
  Similarly, no association was observed among users of histamine-2 receptor antagonists, further strengthening the reliability of the findings.
</p>

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  id="attachment_8731349"
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    data-recalc-dims="1"
    loading="lazy"
    class="size-arc-image-770 wp-image-8731349"
    src="https://www.aljazeera.net/wp-content/uploads/2026/01/shutterstock_2330002975-1769187923.jpg?w=770&amp;resize=770%2C513&amp;quality=80"
    alt="Gastroesophageal reflux disease (GERD) or acid reflux symptoms. Man suffering from heartburn, stomachache, nausea and bloating. Gastrointestinal system disease and digestive problems."
    fetchpriority="low"
  />
  <figcaption id="caption-attachment-8731349" class="wp-caption-text">
    Researchers emphasize the importance of rational use and avoiding prolonged use of acid-reducing medications without medical supervision (Shutterstock)
  </figcaption>
</figure>

<h2 id="why-exclude-a-type-of-stomach-cancer" class="heading-with-anchor">
  Why Exclude a Type of Stomach Cancer?
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</h2>
<p>
  Researchers excluded stomach cancer near the cardia (where the esophagus joins the stomach) to avoid confounding with gastroesophageal reflux disease (GERD), the primary reason for prescribing PPIs.
</p>
<p>
  Because the proposed biological mechanisms for the effects of these drugs do not apply to this type of cancer, the study identified several reasons that may explain false-positive results in previous research, including:
</p>
<ul>
  <li>Accounting for medication use *before* cancer diagnosis.</li>
  <li>Including short-term use.</li>
  <li>Failing to differentiate between types of stomach cancer.</li>
  <li>Insufficient adjustment for <i>H. pylori</i> infection.</li>
</ul>

<h2 id="what-do-the-results-mean-for-patients" class="heading-with-anchor">
  What Do the Results Mean for Patients?
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</h2>
<p>
  These findings provide important reassurance to millions of patients who rely on PPIs for long periods with a clear medical indication, suggesting that long-term use does not appear to increase stomach cancer risk when assessed rigorously.
</p>
<p>
  However, researchers emphasize the importance of rational use and avoiding prolonged use of these medications without medical supervision, given potential other side effects unrelated to cancer.
</p>
<p>
  The study confirms that PPIs are not associated with an increased risk of stomach cancer when used long-term, provided confounding factors are carefully adjusted for. It also underscores the need to prescribe these medications according to medical guidelines, with periodic evaluation of their continued necessity.
</p>
<p>
  <iframe src="https://www.youtube.com/watch?v=mejXV8uOuTM"></iframe>
</p>

<h2 id="risk-factors-for-stomach-cancer" class="heading-with-anchor">
  Risk Factors for Stomach Cancer
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</h2>
<ul>
  <li>Consuming a diet high in smoked foods such as smoked meats and cheeses and salted foods such as "feseekh".</li>
  <li>Not eating enough fruits and vegetables.</li>
  <li>Infection with <i>Helicobacter pylori</i> bacteria, which plays a key role in developing <a href="https://www.aljazeera.net/healthmedicine/digestionsystem/2013/10/7/%D8%A7%D9%84%D9%82%D8%B1%D8%AD%D8%A9-%D8%A7%D9%84%D9%87%D8%B6%D9%85%D9%8A%D8%A9">peptic ulcers</a>.</li>
  <li>Consuming foods contaminated with aflatoxin fungi.</li>
  <li><a href="https://www.aljazeera.net/healthmedicine/addiction/2015/8/20/%D8%A7%D9%84%D8%AA%D8%AF%D8%AE%D9%8A%D9%86-%D8%A3%D8%B3%D9%85%D8%A7%D8%A1-%D9%85%D8%AA%D8%B9%D8%AF%D8%AF%D8%A9-%D9%84%D8%B3%D9%85%D9%91-%D9%88%D8%A7%D8%AD%D8%AF">Smoking</a>.</li>
  <li>Family history of stomach cancer.</li>
  <li><a href="https://www.aljazeera.net/healthmedicine/blood/2014/5/5/%D8%A7%D9%84%D8%A3%D9%86%D9%8A%D9%85%D9%8A%D8%A7">Pernicious anemia</a>.</li>
  <li>Diagnosis of stomach polyps.</li>
  <li>A history of long-term gastritis.</li>
</ul>

<h2 id="symptoms-of-stomach-cancer" class="heading-with-anchor">
  Symptoms of Stomach Cancer
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      xmlns="http://www.w3.org/2000/svg"
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        d="M8 6.75C5.10051 6.75 2.75 9.10051 2.75 12C2.75 14.8995 5.10051 17.25 8 17.25H9C9.41421 17.25 9.75 17.5858 9.75 18C9.75 18.4142 9.41421 18.75 9 18.75H8C4.27208 18.75 1.25 15.7279 1.25 12C1.25 8.27208 4.27208 5.25 8 5.25H9C9.41421 5.25 9.75 5.58579 9.75 6C9.75 6.41421 9.41421 6.75 9 6.75H8Z"
        fill="#1C274C"
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        d="M8.24991 11.9999C8.24991 11.5857 8.58569 11.2499 8.99991 11.2499H14.9999C15.4141 11.2499 15.7499 11.5857 15.7499 11.9999C15.7499 12.4142 15.4141 12.7499 14.9999 12.7499H8.99991C8.58569 12.7499 8.24991 12.4142 8.24991 11.9999Z"
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        d="M15 5.25C14.5858 5.25 14.25 5.58579 14.25 6C14.25 6.41421 14.5858 6.75 15 6.75H16C18.8995 6.75 21.25 9.10051 21.25 12C21.25 14.8995 18.8995 17.25 16 17.25H15C14.5858 17.25 14.25 17.5858 14.25 18C14.25 18.4142 14.5858 18.75 15 18.75H16C19.7279 18.75 22.75 15.7279 22.75 12C22.75 8.27208 19.7279 5.25 16 5.25H15Z"
        fill="#1C274C"
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  </span>
</h2>
<ul>
  <li>Fatigue.</li>
  <li>Feeling bloated or uncomfortable after eating.</li>
  <li>Feeling full after eating only a small amount of food.</li>
  <li><a href="https://www.aljazeera.net/healthmedicine/digestionsystem/2013/10/13/%D8%A7%D9%84%D8%AD%D8%B1%D9%82%D8%A9-%D8%A7%D9%84%D9%87%D8%B6%D9%85%D9%8A%D8%A9-%D9%88%D8%A7%D9%84%D8%A7%D8%B1%D8%AA%D8%AC%D8%A7%D8%B9-%D8%A7%D9%84%D9%85%D9%90%D8%B9%D9%8E%D8%AF%D9%8A-%D8%A7%D9%84%D9%85%D9%8A%D8%B1%D9%8A%D8%A6%D9%8A">Heartburn</a> that is severe and chronic

Samantha Carter oversees all editorial operations at Newsy-Today.com. With more than 15 years of experience in national and international reporting, she previously led newsroom teams covering political affairs, investigative reporting, and global breaking news. Her editorial approach emphasizes accuracy, speed, and integrity across all coverage. Samantha is responsible for editorial strategy, quality control, and long-term newsroom development.

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