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Helicobacter pylori eradication failure may have confounded the recent large-scale health database study that showed proton pump inhibitors increase gastric cancer risk
  1. Hidekazu Suzuki1,
  2. Juntaro Matsuzaki2
  1. 1Fellowship Training Center, Medical Education Center, Keio University School of Medicine, Tokyo, Japan
  2. 2Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo, Japan
  1. Correspondence to Professor Hidekazu Suzuki, Fellowship Training Center, Medical Education Center, Keio University School of Medicine, Tokyo 160-8582, Japan; hsuzuki.a6{at}keio.jp

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The current guidelines recommend that when patients require long-term use of proton pump inhibitors (PPIs), Helicobacter pylori (H. pylori) should be eradicated beforehand because it improves atrophic gastritis, a precancerous lesion.1 2 The recent analysis by Cheung et al3 of the data of more than 60 000 adults registered in a territory-wide health database in Hong Kong who underwent H. pylori eradication showed that the long-term use of PPIs increased the risk of gastric cancer by 2.4-fold. Moreover, the risk of gastric cancer increased with the dose and duration of PPI use. The fact that long-term PPI administration increases the risk of gastric cancer even after H. pylori eradication is unexpected. …

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