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We read with interest the paper by Rugge et al,1 who performed a single-centre study looking at the incidence of gastric cancer in patients with ‘pure’ autoimmune gastritis (AIG). The study has several strengths. First, it aims to fill some gaps about the risk of gastric carcinogenesis with a precise selection of the patients by accurately excluding an active or previous Helicobacter pylori infection. Another point of strength is the relatively long follow-up period. However, despite its undoubted interest, some considerations should be made.
The first point we would like to address relates to the natural history of AIG. In a study performed over a 20-year-long enrolment, 282 AIG patients without active H. pylori infection were included.2 Of these, seven had had an active H. pylori infection and had been included after its eradication, while a past H. pylori infection was excluded only through the medical history. Overall, 17 (6.3%) gastric …
Contributors All authors initially drafted the manuscript. All authors approved the final version of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.