Luis Bujanda
Specialist in Digestive System at Donostia University Hospital, coordinator of the Liver and Gastrointestinal Diseases Area at the Biogipuzkoa Institute and professor of Medicine at the University of the Basque Country (UPV/EHU)
There has always been much controversy surrounding the side effects of proton pump inhibitors (PPIs). In general, we have been using omeprazole (Losec) for more than 25 years. PPIs are used by more than 20% of the population and no significant effects have been observed.
Regarding the press release, it is important to note that antacids should not be confused with proton pump inhibitors. Antacids include, for example, almagate (such as Almax), aluminium hydroxide, magnesium hydroxide, sodium bicarbonate, etc. Proton pump inhibitors include omeprazole, lansoprazole, rabeprazole, esomeprazole, and pantoprazole.
As for the research, it appears to be a well-conducted study that does not associate the use of PPIs with gastric cancer, but it is observational and based on records, where the information is biased. It also does not mention the type or dose of PPI and defines long term as more than one year. The study mentions that 3.1% of cases eradicate H. pylori but does not mention the infection rate in that population, which is generally higher than 25-30%.
Furthermore, they only analyse one type of gastric cancer, adenocarcinoma. What about gastric neuroendocrine tumours? They are very rare, but there could be a link with the use of PPIs. This is a cohort study, and the diet and family history of gastric cancer are unknown, as the article states.
Finally, it should be noted that the incidence of gastric cancer is decreasing. It would be good to assess whether taking PPIs increases the risk of oesophageal-gastric cancer.