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We read four manuscripts published in Gut about the relationship between proton pump inhibitors use and gastric cancer.1–4 Proton pump inhibitors are widely used for the management of peptic ulcer disease, gastroesophageal reflux disease and eradication of Helicobacter pylori infection.5 However, its safety for long-term use has raised pubic concern.6 In order to clarify the relationship between proton pump inhibitors use and gastric cancer, we used the 2000–2013 database of Taiwan National Health Insurance Program to conduct a population-based case–control study. The study design and data source were adapted from previous studies.7 8 Subjects aged 20–84 years with newly diagnosed gastric cancer were selected as the cases. Subjects without gastric cancer were randomly selected from the same database as the matched controls. The index date was defined as the date of each case being diagnosed with gastric cancer. Both cases with gastric cancer and matched controls were matched with sex, age (every five years) and the year of index date. In order to reduce the latency bias, subjects whose first-time prescriptions for proton pump …
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