Does omeprazole cause cancer

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Does Omeprazole Cause Cancer?

Introduction to Omeprazole and Its Uses

Omeprazole is a widely used proton pump inhibitor (PPI) primarily prescribed to treat gastrointestinal disorders such as ulcers and gastroesophageal reflux disease (GERD). While its efficacy in managing these conditions is well-documented, concerns have been raised about its long-term safety, particularly regarding its potential to cause cancer.

Omeprazole and Gastric Cancer Risk

Several studies have investigated the relationship between long-term omeprazole use and the risk of gastric cancer. Research indicates that prolonged use of omeprazole can lead to genomic instability, which may increase the risk of gastric cancer . This genomic instability is associated with various adverse effects, including atrophic gastritis, cobalamin deficiencies, and the development of gastric polyps .

Protective Effects Against Colorectal Cancer

Interestingly, omeprazole has shown protective effects against colorectal cancer in animal models. Studies have demonstrated that omeprazole can inhibit the progression of colorectal carcinogenesis induced by azoxymethane in rats, despite causing hypergastrinaemia . Additionally, omeprazole has been found to suppress the formation of colonic aberrant crypt foci and reduce the incidence and multiplicity of colonic adenocarcinomas in rats 456. These findings suggest that omeprazole may have chemopreventive properties against colorectal cancer.

Carcinogenic Potential in Combination with Nitrosamines

However, the carcinogenic potential of omeprazole may be influenced by other factors. For instance, a study on mice revealed that omeprazole, when combined with the carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), promoted carcinogenesis in the fore-stomach but not in the glandular stomach . This suggests that omeprazole's carcinogenic effects may be context-dependent and influenced by the presence of other carcinogens.

Impact on Pancreatic and Gastric Cancer Cells

Omeprazole has also been studied for its effects on pancreatic and gastric cancer cells. In pancreatic cancer cells, omeprazole inhibited proliferation and modulated autophagy, leading to programmed cell death . In gastric cancer cells, omeprazole improved chemosensitivity by activating the mTORC1 pathway and upregulating the apoptosis-related gene DDIT3 . These findings indicate that omeprazole may have complex interactions with cancer cells, potentially offering therapeutic benefits in certain contexts.

Conclusion

The relationship between omeprazole and cancer is multifaceted. While long-term use of omeprazole may increase the risk of gastric cancer due to genomic instability, it also exhibits protective effects against colorectal cancer in animal models. Additionally, its impact on other types of cancer cells suggests potential therapeutic applications. Given these mixed findings, it is crucial for healthcare providers to weigh the benefits and risks of long-term omeprazole use and consider individual patient factors when prescribing this medication. Further research is needed to fully understand the mechanisms underlying omeprazole's effects on cancer risk and to develop guidelines for its safe use.

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Most relevant research papers on this topic

Pharmacological Effects and Toxicogenetic Impacts of Omeprazole: Genomic Instability and Cancer

Long-term use of omeprazole may induce genomic instability and increase the risk of certain types of cancer, requiring adequate precautions.

Systematic ReviewRigorous Journal

2020·

21citations

·M. F. C. J. Paz et al.

Omeprazole inhibits colorectal carcinogenesis induced by azoxymethane in rats.

Omeprazole protects against colorectal carcinogenesis in rats, despite causing significant hypergastrinaemia, suggesting a potential protective mechanism for humans.

RCTAnimal Study

1993·

41citations

·I. D. Penman et al.

Omeprazole promotes carcinogenesis of fore-stomach in mice with co-stimulation of nitrosamine

Omeprazole promotes carcinogenesis of the mouse fore-stomach when combined with nitrosamine, but not the glandular stomach, due to inhibition of lysosomal hydrolase activity and dysregulation of cancer-associated proteins.

RCTAnimal StudyRigorous Journal

2017·

13citations

·Lei Huang et al.

[Corrigendum] Anti-carcinogenic properties of omeprazole against human colon cancer cells and azoxymethane-induced colonic aberrant crypt foci formation in rats

Omeprazole shows anti-carcinogenic properties against colon cancer cells, suppressing colonic aberrant crypt foci formation and inducing anti-apoptotic signals in rats.

2011·

41citations

·J. Patlolla et al.

Proton Pump Inhibitor Omeprazole Suppresses Carcinogen-induced Colonic Adenoma Progression to Adenocarcinoma in F344 Rat

Omeprazole, a common medication for treating acid reflux, effectively suppresses colonic adenoma progression to carcinoma in a rat model, warranting further human evaluation.

Non-RCTAnimal Study

2021·

5citations

·Venkateshwar Madka et al.

Abstract 2820: Omeprazole alone, or in combination with Aspirin inhibits azoxymethane-induced colon adenoma progression to adenocarcinoma and carcinoma invasion in F344 rat model

Omeprazole alone or combined with aspirin significantly inhibits colon adenocarcinoma progression and carcinoma invasion in rats, with potential chemopreventive effects.

Non-RCTAnimal Study

2015·

2citations

·Altaf Mohammed et al.

Omeprazole Inhibits Proliferation and Modulates Autophagy in Pancreatic Cancer Cells

Omeprazole inhibits pancreatic cancer cell proliferation and modulates autophagy, potentially circumventing common resistance mechanisms and leading to new clinical applications.

In Vitro StudyHighly Cited

2011·

94citations

·A. Udelnow et al.

Omeprazole improves chemosensitivity of gastric cancer cells by m6A demethylase FTO-mediated activation of mTORC1 and DDIT3 up-regulation

Omeprazole improves chemosensitivity of gastric cancer cells by enhancing the activation of mTORC1 and DDIT3 expression, potentially benefiting patients with advanced gastric cancer.

In Vitro StudyRigorous Journal

2021·

32citations

·S. Feng et al.

Omeprazole and dietary nitrate independently affect levels of vitamin C and nitrite in gastric juice.

Omeprazole and dietary nitrate independently decrease the ascorbate/nitrite ratio, potentially increasing the risk of gastric cancer.

Non-RCTHighly Cited

1999·

127citations

·C. Mowat et al.

A prospective, randomized, placebo-controlled, double-blinded clinical trial comparing the incidence and severity of gastrointestinal adverse events in dogs with cancer treated with piroxicam alone or in combination with omeprazole or famotidine.

Omeprazole did not reduce gastrointestinal adverse events and may have increased them in dogs with cancer treated with single agent piroxicam, suggesting it should not be used as a prophylaxis with NSAIDs.

RCTAnimal Study

2021·

15citations

·Marejka H Shaevitz et al.

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