To the Editor: In their Editorial about the
relationship between Helicobacter pylori and gastric
carcinoma, Drs Parsonnet and Forman1 did
not discuss the dramatic decline in the use of salting and pickling food for
preservation, which has mirrored the decline in US cases of gastric cancer
during this period.2 Worldwide, there has
been an ongoing reduction in salt intake.3,4 There
is some evidence that the relevant carcinogens are produced from specific
food items, such as those in fish, by salting and pickling, which involves
the use of large amounts of salt and nitrates.5 Reducing
salt intake may decrease the risk of gastric cancer, irrespective of the presence
of H pylori.