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We read with great interest the recent publication written by Lee et al 1 in which the authors conducted a prospective, longitudinal and multicentre study to evaluate the association between intestinal metaplasia (IM) and gastric cancer (GC). As expected, IM was found to be a significant risk factor for GC (adjusted HR (aHR) 5.46; 95% CI 1.51 to 19.0). Nevertheless, operative link on gastric IM (OLGIM) staging was more closely correlated with the risk of GC (stage III/IV; aHR 20.7; 95% CI 5.04 to 85.6, and stage II; aHR 7.34; 95% CI 1.60 to 33.7). They concluded that risk stratification of GC based on OLGIM staging was useful for endoscopic surveillance.
We agree with their results that OLGIM staging is the most important predictor for GC, although there are many other risk factors of GC. According …
Contributors JA, RN and YH contributed to the study design. JA wrote the initial manuscript draft. JA, RN and YH analysed the data. TA, AY, TK and MF provided guidance regarding the study design and contributed to manuscript editing.
Funding This study was funded by KAKENHI Grants-in-Aid for Scientific Research (17H05081, 20K08375, YH), P-CREATE from AMED (RN and YH), and the Advanced Research and Development Programs for Medical Innovation (PRIME, YH).
Disclaimer The funding agencies had no role in the design of the study, data collection or analyses, decision to publish, or preparation of the manuscript.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; internally peer reviewed.