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We read with interest the study by Cheung et al confirming the risk of proton pump inhibitors (PPIs) for gastric cancer regarding the patients after Helicobacter pylori (H. pylori) eradication with long-term PPIs use.1 Most concerns about the safety of PPIs pertain to the increased risk for enteric infections, fractures and nutritional deficiencies.2 To date, the association of PPIs use and risk of gastric cancer is still controversial in patients with gastro-oesophageal reflux diseases (GERD).
For GERD, PPIs are the mainstay of treatment in the management of patients with acid-related disorders.3 Thus, patients with GERD usually take long-term PPIs,and possibly carry the risk of gastric cancer. In the present study, we performed a case–control study to investigate the association of PPIs use and risk of gastric cancer using data from a nationwide population database, the National Health Insurance Research Database (NHIRD) in Taiwan.4
This study also used a subdataset of the NHIRD, which comprises one million randomly sampled beneficiaries enrolled in the NHI programme in 2000 (Longitudinal Health Insurance Database …
Y-CP and L-RH contributed equally.
Contributors Y-CP, C-LL and C-HK: conception and design; collection and assembly of data; data analysis and interpretation. C-HK: administrative support. All authors: manuscript writing; final approval of manuscript.
Funding This work was supported by grants from the Ministry of Health and Welfare, Taiwan(MOHW107-TDU-B-212-123004), China Medical University Hospital; Academia Sinica Stroke Biosignature Project (BM10701010021); MOST Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005-); Tseng-Lien Lin Foundation, Taichung, Taiwan; and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.
Competing interests None declared.
Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.
Ethics approval This study was exempted by the Institutional Review Board of China Medical University in Central Taiwan (CMUH104-REC2-115-CR2).
Provenance and peer review Not commissioned; internally peer reviewed.
Data sharing statement The dataset used in this study is held by the Taiwan Ministry of Health and Welfare (MOHW). The Ministry of Health and Welfare must approve our application to access this data. Any researcher interested in accessing this dataset can submit an application form to the ministry of health and welfare requesting access. Please contact the staff of MOHW (Email: email@example.com) for further assistance. Taiwan Ministry of Health and Welfare Address: No.488, Sec. 6, Zhongxiao E. Rd., Nangang Dist., Taipei City 115, Taiwan (R.O.C.). Phone: +886-2-8590-6848. All relevant data are within the paper.
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