BMJ

Does long-term use of acid reducers increase gastric cancer risk?

January 23, 2026

A large Nordic case‑control study found no association between long‑term proton pump inhibitor (PPI) use and gastric adenocarcinoma, with an adjusted odds ratio of 1.01 (95% confidence interval [CI], 0.96–1.07); risk estimates were similarly neutral for H2‑receptor antagonists (adjusted odds ratio, 1.03; 95% CI, 0.86–1.23). Multiple sources of prior false‑positive associations were identified, including PPI use shortly before diagnosis, short‑term exposure, inclusion of cardia adenocarcinoma, and lack of adjustment for H. pylori–related variables.

Clinical takeaway: For patients with appropriate indications, long-term PPI therapy appears unlikely to increase stomach cancer risk, providing reassurance when ongoing acid suppression is clinically necessary.

Source:

Duru O, et al. (2026, January 21). BMJ. Long term use of proton pump inhibitors and risk of stomach cancer: population based case-control study in five Nordic countries. https://pubmed.ncbi.nlm.nih.gov/41565320/