SynthesisBMJ open gastroenterology2025
Proton pump inhibitors and the risk of gastric cancer: a systematic review, evidence synthesis and life course epidemiology perspective.
Synthesis in BMJ open gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between map-like redness and the risk of gastric cancer and high-risk precancerous lesions: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Bioinspired Quinoline-2 Derivatives Based on the Natural Alkaloid 2-Phenylquinoline fromMolecules (Basel, Switzerland) · 2026Article
- Carcinogenic Medications: A Review of Specific Agents and Molecular Mechanisms of Carcinogenesis.Cancer reports (Hoboken, N.J.) · 2026Review
- Balancing therapeutic benefits and hidden risks of proton pump inhibitors in pediatric practice: a narrative review and update.Clinical and experimental pediatrics · 2026Article
- Long term use of proton pump inhibitors and risk of stomach cancer: population based case-control study in five Nordic countries.BMJ (Clinical research ed.) · 2026Article
- Perspectives on gastric cancer: the central role of gastrin in carcinogenesis byFrontiers in oncology · 2026Review
- The Use of Proton Pump Inhibitors Among Adults in Norway-A Nationwide Drug Utilization Study.Pharmacology research & perspectives · 2025Article
- Pharmacodynamics, pharmacokinetics, interactions with other drugs, toxicity and clinical effectiveness of proton pump inhibitors.Frontiers in pharmacology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSince proton pump inhibitors (PPI) have been introduced, many concerns were raised regarding potential gastric carcinogenicity. We aim to summarise and weigh the epidemiological evidence and address possible causality.
designSystematic literature review, evidence synthesis and life-course assessment. DATA SOURCES: PubMed, Web of Science and Cochrane database (from inception up to October 2024), and back- and forward citation tracking (Web of Science). ELIGIBILITY CRITERIA: Original studies and quantitative evidence syntheses assessing the association between PPIs and gastric cancer in humans, without language restrictions. DATA EXTRACTION AND SYNTHESIS: Study design, definitions (and participant numbers) of PPI use and gastric cancer, study characteristics (setting, period, follow-up, lag-time), age and sex distribution presented in tables and evidence mapping.
resultsWe identified 33 original studies, 21 meta-analyses, three umbrella meta-analyses, one individual patient data meta-analysis and a Markov model (2006-2023). PPIs were consistently associated with an increased gastric cancer risk with 20/21 meta-analyses reporting pooled relative risks between 1.3 and 2.9. Available trials were underpowered. Reverse causation/protopathic bias, residual confounding (by indication) and lag time seem the largest methodological challenges, as well as disentangling the effects of
conclusionAlthough for older individuals with valid indications, the gastric cancer risk related to PPI use may be limited, we do argue for a more rational and evidence-supported use of PPIs in young populations.
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