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Secondary prevention of gastric cancer: merging the endoscopic atrophic border with OLGA staging
  1. Massimo Rugge1,
  2. Diana Sacchi2,
  3. David Y Graham3,
  4. Robert M Genta4
  1. 1 Veneto Tumor Registry, Padova, Italy; Department of Medicine DIMED Pathology and Cytopathology Unit, University of Padova, Padova, Italy
  2. 2 DIMED, University of Padova School of Medicine and Surgery, Padova, Italy
  3. 3 Medicine (111D), Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
  4. 4 Pathology, Veterans Affairs North Texas Health Care System, Dallas, Texas, USA
  1. Correspondence to Dr Massimo Rugge, Department of Medicine (DIMED), University of Padova, 35122 Padova PD, Italy; massimo.rugge{at}

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First, we wish to thank Dr Quach and his coauthors1 for their interest in our study. We are flattered by their statement that our numbers are ‘quite convincing’ and will attempt to mitigate their concerns.2

The authors are correct in that the eradication of Helicobacter pylori does not abolish all gastric cancer (GC) risk in patients with long-standing atrophic gastritis.3–5 This broad statement, however, requires some clarifications.

  • The operative link for gastritis assessment (OLGA) Group was and is aware of the limitations of the staging system. Gastritis staging should be viewed as a step forward in improving the consistency of the interdisciplinary communication of GC risk in individual patients. …

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  • Contributors Submitted by MR as the corresponding author.

  • Competing interests None declared.

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

  • Patient consent for publication Not required.