J Dig Cancer Res.  2022 Jun;10(1):9-15. 10.52927/jdcr.2022.10.1.9.

Long Term Proton Pump Inhibitor Use and Gastric Cancer

• Seo SI

• KMID: 2530343
• DOI: http://doi.org/10.52927/jdcr.2022.10.1.9

Abstract

Proton pump inhibitors (PPIs), a potent gastric acid inhibitor, are widely used in gastric acidrelated diseases such as gastroesophageal reflux disease and peptic ulcer, and are known as the most frequently used drugs worldwide. However, as the frequency of use increases, the number of cases of long-term PPI therapy without clear indications is increasing. Recently, there have been concerns about the risk of gastric cancer in patients with long-term PPI users. Potential mechanisms for the association between PPI and gastric cancer include enterochromaffin-like cell proliferation due to hypergastrinemia caused by gastric acid suppression, progression of atrophic gastritis, and corpus-predominant type through interaction with Helicobacter pylori (H. pylori) infection. Several epidemiologic studies showed controversial results on the issue, and it is difficult to prove a causal relationship between PPI and gastric cancer. Nevertheless, long-term PPI should be administered cautiously based on individual risk-benefit profile, specifically among those with history of H. pylori infection, in high-risk region of gastric cancer.

Keyword

Proton pump inhibitors; Gastric cancer