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We read with interest the article by Cheung et al 1 reporting an increased risk of gastric cancer with long-term exposure to proton pump inhibitors (PPI) following Helicobacter pylori (HP) eradication. Several recent reports and a meta-analysis have also demonstrated this association.2 3 The present study, using strict exclusion criteria, was able to adjust for the confounding effect of previous HP infection and eradication, demonstrating a PPI exposure-dependent escalating risk for non-cardia gastric cancer (NCGC) in previously infected patients. The authors suggest that the profound acid suppression by PPIs worsens the atrophic gastritis induced by HP infection, …
Contributors IG and HH raised the conception and performed the literature survey. All authors contributed to the writing of the letter. IG is the guarantor.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
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