Sawaied IO, Samson AO, Golan E. Patients’ perception of proton pump inhibitors use and their risks. World J Clin Oncol 2026; 17(1): 113463 [DOI: 10.5306/wjco.v17.i1.113463]
Corresponding Author of This Article
Ibrahim O Sawaied, Azrieli Faculty of Medicine, Bar-Ilan University, Henrietta Szold Street 8, Safed 2170000, Israel. ibomsa13@gmail.com
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Gastroenterology & Hepatology
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Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 24, 2026 (publication date) through Jan 28, 2026
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World Journal of Clinical Oncology
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2218-4333
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Sawaied IO, Samson AO, Golan E. Patients’ perception of proton pump inhibitors use and their risks. World J Clin Oncol 2026; 17(1): 113463 [DOI: 10.5306/wjco.v17.i1.113463]
World J Clin Oncol. Jan 24, 2026; 17(1): 113463 Published online Jan 24, 2026. doi: 10.5306/wjco.v17.i1.113463
Patients’ perception of proton pump inhibitors use and their risks
Ibrahim O Sawaied, Abraham O Samson, Efrat Golan
Ibrahim O Sawaied, Abraham O Samson, Azrieli Faculty of Medicine, Bar-Ilan University, Safed 2170000, Israel
Efrat Golan, Department of Pediatric Medicine, Haemek Hospital, Afula 2170000, Israel
Author contributions: Sawaid IO, Samson AO, and Golan E designed the research study; Sawaid IO and Golan E performed the research; Sawaid IO analyzed the data and drafted the manuscript; Samson AO critically revised the manuscript and supervised the project; All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Human Subjects Institutional Review Board at Bar-Ilan University, Ramat Gan, Israel (Approval No. 300625649).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Technical appendix, statistical code, and anonymized dataset are available from the corresponding author at ibomsa13@gmail.com. All data have been de-identified to protect participant confidentiality.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ibrahim O Sawaied, Azrieli Faculty of Medicine, Bar-Ilan University, Henrietta Szold Street 8, Safed 2170000, Israel. ibomsa13@gmail.com
Received: August 26, 2025 Revised: September 15, 2025 Accepted: December 23, 2025 Published online: January 24, 2026 Processing time: 147 Days and 15.8 Hours
Abstract
BACKGROUND
Long-term proton pump inhibitor (PPI) therapy is widely prescribed for acid-related disorders. Emerging evidence associates prolonged use with potential adverse outcomes, including gastric cancer. Despite increasing prescriptions, little is known about patients’ awareness of these risks or factors influencing discontinuation. We hypothesized that limited risk awareness and family support significantly affect patients’ willingness to deprescribe PPIs.
AIM
To evaluate patients’ awareness of PPI risks and factors associated with deprescribing.
METHODS
A cross-sectional observational study was conducted in community clinics and pharmacies across Israel, including 3000 adult PPI users recruited consecutively. Participants completed a multilingual survey (Hebrew, Arabic, Russian) assessing risk awareness, family support, and quality of life. A composite risk scale (0-12) was used to quantify perceived cancer risk. Descriptive statistics and multivariate logistic regression were performed to identify factors associated with high-risk awareness and willingness to discontinue PPIs.
RESULTS
Among 3000 participants, fatigue occurred in 20%, constipation in 31.3%, infections in 9.3%, renal issues in 4.6%, and no side effects in 12.5%. Pantoprazole cancer-risk perception was 26.5%. Overall, 30% desired to discontinue PPIs and 15% reported symptom recurrence. High composite risk score (≥ 2) was associated with family support [odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.3-2.8; P < 0.01] and longer PPI use (> 1 year; OR = 1.6, 95%CI: 1.1-2.4; P = 0.02). Attempted discontinuation correlated with high-risk score (OR = 2.1, 95%CI: 1.5-3.0; P < 0.001).
CONCLUSION
Patients show limited awareness of long-term PPI risks. Family support and longer treatment duration are strongly associated with higher risk awareness and willingness to discontinue PPIs.
Core Tip: This study is among the largest cross-sectional surveys of proton pump inhibitor users, involving 3000 patients across Israel. We found that most patients are unaware of the risks associated with long-term proton pump inhibitor therapy, including the potential link to gastric cancer. Despite lansoprazole showing a safer profile and greater improvements in quality of life, it remains underutilized compared with omeprazole and esomeprazole. Family support emerged as a protective factor, encouraging deprescribing attempts and improving patient outcomes. These findings highlight the need for better patient education, risk communication, and alignment of prescribing practices with current clinical evidence.
