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​Patients on PPIs more than twice as likely to develop gastric cancer, study finds


I do not think this study demonstrates a causal relationship between PPI and gastric cancer. The association between atrophic gastritis (AG) and gastric cancer (GC) has been known for a long time. AG represents the end stage of chronic gastritis, both infectious and autoimmune. In both cases, the clinical manifestations of atrophic gastritis are those of chronic gastritis, but pernicious anemia is observed specifically in patients with autoimmune gastritis and not in those with H pylori–associated atrophic gastritis. The latter has been perhaps more often associated with diagnosis of GC. It is therefore hardly surprising that, among all the people - many - taking PPI consistently for a long time there should be a good proportion with AG, hence at increased risk of GC. If PPI were to be blamed for GC, then I would have expected an increased prevalence of GC when compared to the '80s. The opposite appears to be true. That being said, I find concerning for the very same reasons that patient on regular PPI are not reviewed regularly.

Posted date

03 Nov 2017

Posted time