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Risk factors for gastric cancer: is it time to discard PPIs?
  1. Lucrezia Laterza,
  2. Franco Scaldaferri,
  3. Antonio Gasbarrini
  1. Internal Medicine, Gastroenterology and Hepatic Diseases Unit, Gastroenterological Area, Gastroenterological and Endocrino-Metabolical Sciences Department, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
  1. Correspondence to Dr Lucrezia Laterza, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy; laterza.lucrezia{at}

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We read with great interest the paper by Cheung et al recently published in your journal.1 The extensive worldwide use of proton pump inhibitors (PPIs) makes the debate about a related risk of gastric cancer a very popular and current topic.2 Potentially, the PPI-induced reduction of acid content in the stomach may contribute to gastric cancer pathogenesis, possibly by increasing gastrin secretion, with a resultant constant trophic stimulus on the gastric mucosa, similar to Helicobacter pylori-related chronic atrophic gastritis.3 These conditions may both feasibly share a similar alteration of the gastric microbiota.4

However, evidence on this topic is not definitive: two meta-analyses of randomised controlled trials found no correlation between gastric cancer and long-term PPI use,5 6 whereas a meta-analysis of observational …

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  • Contributors LL wrote the commentary. FS and AG provided intellectual contribution and correction of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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