Secondary prevention of gastric cancer: merging the endoscopic atrophic border with OLGA staging

[...]we wish to emphasise that we do not see a dichotomy between the ‘histology-based’ and the ‘endoscopy-based’ prediction of GC risk. Innumerable potentially useful biopsy samples have been and continue to be discarded after using them for the urea-based assessment of H. pylori infection, which could be equally or better detected by histology while simultaneously providing useful information on the state of the gastric mucosa.9 We are in complete agreement with Dr Quach and his coauthors’ position that an ethical approach requires centring prevention strategies on our patients. While the availability of different technical methodologies and the conditions of local health-system networks are pivotal to the strategies chosen, we should always attempt to use the best available of different, yet complementary, diagnostic approaches (serology, endoscopy, pathology) framed in the epidemiological context of H. pylori prevalence and GC incidence.10 Contributors Submitted by MR as the corresponding author.