Is there an association between gastric cancer and the use of proton pump inhibitors?

This is the strongest evidence to date that there is a small but clinically significant increase in the risk of gastric cancer for patients taking a PPI (number needed to treat to harm = 1191 over 10 years). Physicians initiating anti-acid therapy for patients should begin with an H2RA, and if prescribing a PPI, should use the lowest dose and duration possible. Another recent study in the same journal using data from a Korean registry produced similar findings (Gut 2021;70:2066-2075 doi:10.1136/gutjnl-2020-323845).