Gastric cancer is the fifth leading cancer worldwide. Infection with Helicobacter pylori represents the major risk factor, but only a small fraction of infected individuals will develop neoplasia. The progression of advanced gastric lesions to cancer is influenced by characteristics of the bacterial strain, host genetic and environmental factors. Recently, the effect of medications on gastric cancer risk has gained interest, because many commonly prescribed drugs affect gastric homeostasis. While non-steroidal anti-inflammatory drugs (NSAIDs) are a frequent cause of gastric ulcer disease, low-dose aspirin has been propagated for chemoprevention of various tumour entities. Beneficial effects of cyclooxygenase-inhibition for gastric cancer prevention is plausible, but its clinical relevance remains unclear. Furthermore, anti-tumorous effects have been postulated for statins and metformin. On the contrary, proton pump inhibitors (PPIs), which are commonly used for prevention of gastric ulcers and bleeding, have been associated with an increased gastric cancer risk in large observational studies. Most of these observations still require confirmation in prospective controlled trials. NSAIDs, statins and metformin have also been investigated as concomitant cancer treatment, but studies did not show convincing results to date. Here, we review the available evidence and possible mechanisms for the role of PPIs, NSAIDs, statins and metformin in gastric carcinogenesis, and discuss possible implications for clinical practice.

胃癌是全球第五大癌症。感染幽门螺杆菌代表主要的危险因素，但只有一小部分受感染的个体会发展成瘤。晚期胃部病变发展为癌症的过程受细菌菌株，宿主遗传因素和环境因素的影响。近来，药物对胃癌风险的影响已引起人们的兴趣，因为许多常用处方药物会影响胃稳态。虽然非甾体类抗炎药（NSAIDs）是胃溃疡疾病的常见原因，但低剂量阿司匹林已广为传播，可用于各种肿瘤实体的化学预防。环氧合酶抑制对预防胃癌的有益作用似乎是合理的，但其临床相关性尚不清楚。此外，已假定他汀类药物和二甲双胍具有抗肿瘤作用。相反，质子泵抑制剂（PPI）大型观察性研究表明，常用于预防胃溃疡和出血的药物与胃癌风险增加有关。这些观察中的大多数仍然需要在前瞻性对照试验中进行确认。非甾体抗炎药，他汀类药物和二甲双胍也已作为伴随癌症的治疗方法进行了研究，但迄今为止，研究尚未显示令人信服的结果。在这里，我们审查了PPI，NSAID，他汀类药物和二甲双胍在胃癌发生中的作用的可用证据和可能的机制，并讨论了对临床实践的可能含义。他汀类药物和二甲双胍也已作为伴随癌症的治疗方法进行了研究，但迄今为止研究尚未显示令人信服的结果。在这里，我们审查了PPI，NSAID，他汀类药物和二甲双胍在胃癌发生中的作用的可用证据和可能的机制，并讨论了对临床实践的可能含义。他汀类药物和二甲双胍也已作为伴随癌症的治疗方法进行了研究，但迄今为止研究尚未显示令人信服的结果。在这里，我们审查了PPI，NSAID，他汀类药物和二甲双胍在胃癌发生中的作用的可用证据和可能的机制，并讨论了对临床实践的可能含义。