ArticleBMJ (Clinical research ed.)2026
Long term use of proton pump inhibitors and risk of stomach cancer: population based case-control study in five Nordic countries.
Article in BMJ (Clinical research ed.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Long-Term Proton Pump Inhibitor Use and Gastric Cancer Risk: Interpreting Population-Based Evidence.Gut and liver · 2026Article
- Proton Pump Inhibitors Prescribing Behaviors and Rationalization Strategies Among Healthcare Providers in Southeast Asia.Pharmacology research & perspectives · 2026Article
- Perspectives on gastric cancer: the central role of gastrin in carcinogenesis byFrontiers in oncology · 2026Review
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo help to clarify whether long term use of proton pump inhibitors is associated with an increased risk of gastric adenocarcinoma by designing a study that considered the existing literature's methodological weaknesses.
designPopulation based case-control study using prospectively collected data from multiple complete nationwide registries in five Nordic nations.
settingAll healthcare in five Nordic countries-Denmark, Finland, Iceland, Norway, and Sweden-between 1994 and 2000.
participantsCase patients with gastric adenocarcinoma, each matched for age, sex, calendar year, and country with 10 control participants randomly identified from each country's entire population. EXPOSURE: The exposure was long term (>1 year) proton pump inhibitor use, excluding the 12 months before the diagnosis date (cases) or inclusion date (controls). Long term (>1 year) use of histamine-2-receptor antagonists was analysed to assess the validity and specificity of the findings for proton pump inhibitor use MAIN OUTCOMES MEASURES: The outcome was gastric non-cardia adenocarcinoma. Gastric cardia adenocarcinoma was excluded to avoid confounding by indication (that is, gastro-oesophageal reflux). As well as controlling for the matching variables, multivariable logistic regression provided odds ratios with 95% confidence intervals, adjusted for country,
resultsThe study included 17 232 cases of gastric (non-cardia) adenocarcinoma and 172 297 controls. Long term proton pump inhibitor use occurred in 1766 (10.2%) cases and 16 312 (9.5%) controls. No association was found between long term proton pump inhibitor use and gastric adenocarcinoma (adjusted odds 1.01, 95% confidence interval 0.96 to 1.07). The risk was similar for histamine-2-receptor antagonist use (adjusted odds ratio 1.03, 0.86 to 1.23). Multiple sources of error that led to a false positive association were identified-inclusion of proton pump inhibitor use shortly before the gastric adenocarcinoma diagnosis, short term use of proton pump inhibitors, cardia adenocarcinoma, and lack of adjustment for
conclusionsLong term proton pump inhibitor use may not be associated with an increased risk of gastric adenocarcinoma.
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