Risk of stomach cancer in patients with peptic ulcer disease

The relation between peptic ulcer and stomach cancer has long been disputed , but there is accumulating evidence that gastric ulcer disease is positive ly associated and duodenal ulcerations negatively associated with the risk of developing stomach cancer. As Helicobacter pylori infection is associate d with both types of ulceration and stomach cancer. the varying outcomes of the infection indicate that factors other than the infection must be of im portance. At present, there is no convincing evidence that pharmacologic in hibition of acid secretion for treatment of peptic ulcer increases the risk of stomach cancer. However, some recent studies indicate that prolonged tr eatment with proton pump inhibitors may accelerate the development of atrop hic gastritis, a risk factor for stomach cancer, in individuals infected wi th H. pylori. It has repeatedly been shown that there is an at least twofol d increased risk of stomach cancer 15 gears after gastric resection for pep tic ulcer disease, and that the risk increases with the passage of time. Wh ether vagotomy has the same risk-increasing effect is still unclear.