By the way, doctor: Does long-term use of Prilosec cause stomach cancer?

Content provided by the Faculty of the Harvard Medical School

By the way, doctor: Does long-term use of Prilosec cause stomach cancer?

By the way, doctor

Does long-term use of Prilosec cause stomach cancer?

Q. I've been taking Prilosec for over a year for GERD. Recently, I read that long-term use of proton pump inhibitors increases the risk of certain gastric cancers. Your opinion?

A. Proton pump inhibitors (PPIs) have revolutionized the treatment of gastroesophageal reflux disease (GERD), in which stomach acid flows back into the esophagus and causes heartburn. Brand-name drugs in this class include Prilosec, Nexium, Prevacid, Protonix, Pantoloc, and Aciphex. They all shut down the proton pump, an enzyme involved in the production of stomach acid.

GERD is a chronic condition, so many people need to take a PPI indefinitely to control their symptoms. This has raised some concerns about their long-term use and cancer risk. One worry is that ongoing use of PPIs might mask symptoms of gastric cancer or infection with H. pylori, a bacterium that can cause heartburn, stomach ulcers, and an increased risk for stomach cancer. Unlike GERD, an H. pylori infection usually goes away after treatment (a combination of antibiotics and PPIs). Another concern is that chronic PPI use can cause polyps and atrophic gastritis (irritation of cells lining the stomach), although these conditions have not been shown to result in cancer in any study of long-term PPI use in humans.

We have about 20 years of experience with PPIs, but we don't know all the effects of lifetime use. Thus far, any cancer risk associated with the drugs is theoretical and not borne out in clinical studies. Moreover, PPIs are an essential part of our armamentarium against chronic GERD, which, left untreated, can increase the risk of esophageal cancer. If your PPI is not effectively treating your GERD symptoms, let your clinician know. She or he may want to investigate other possible causes of your discomfort.

— Celeste Robb-Nicholson, M.D. Editor in Chief, Harvard Women's Health Watch

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Last updated:	September 05, 2008

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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