Evidence map›Paper›PMID 26215280›Full record

Observational studyBMJ (Clinical research ed.)2015

Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population.

Huan Song, Isabella Guncha Ekheden, Zongli Zheng, Jan Ericsson, Olof Nyrén, Weimin Ye

Erratum issuedOpen access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 160 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
160citing papers in PubMed, 13 pooled it
16.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

160 citing papers in PubMed, 13 syntheses or guidelines pooled it, 312 citations in OpenAlex.

  1. Argon plasma coagulation versus endoscopic resection for the treatment of gastric adenomas: A systematic review and meta-analysis.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2025
    Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
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  7. Clinical Practice Guideline for Gastritis in Korea.Journal of Korean medical science · 2023
    Guideline
  8. Pooled it
  9. Pooled it
  10. Guideline
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Diagnosing and grading gastric atrophy and intestinal metaplasia using semi-supervised deep learning on pathological images: development and validation study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024
    Trial
  15. Trial
  16. Dynamics ofGut · 2018
    Trial
  17. Article
  18. Autoimmune gastritis: emerging insights and clinical management.Nature reviews. Gastroenterology & hepatology · 2026
    Review
  19. Review
  20. Article

100 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Huan SongDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Isabella Guncha EkhedenDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Zongli ZhengDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Jan EricssonDepartment of Pathology, Karolinska Hospital, Sweden.
Olof NyrénDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Weimin YeDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden weimin.ye@ki.se.
Karolinska Institutet · SEKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo accurately measure the incidence of gastric cancer among patients with gastric precancerous lesions, and to quantify the excess incidence in comparison with people with normal mucosa on endoscopy and a general population.

designPopulation based cohort study.

settingPopulation of Sweden using data from its national disease registers.

participants405,172 patients who had gastric biopsy samples taken for non-malignant indications between 1979 and 2011.

main outcome measuresIncidence of gastric cancer, reported separately for patients with different mucosal changes in biopsy samples. Standardised incidence ratios provided estimation of the relative risk, using the general Swedish population as reference; and hazard ratios were derived from Cox regression modelling for internal comparisons with patients with normal gastric mucosa.

resultsAfter excluding the first two years of follow-up, 1599 cases of gastric cancer were identified. The annual crude incidence of gastric cancer was 20 × 10(-5) for those in the normal mucosa group (standardised incidence ratio 1.0), 42 × 10(-5) for those with minor changes (1.5), 59 × 10(-5) for the gastritis group (1.8), 100 × 10(-5) for the atrophic gastritis group (2.8), 129 × 10(-5) for the intestinal metaplasia group (3.4), and 263 × 10(-5) for the dysplasia group (6.5). Cox regression modelling confirmed that excess risks increased monotonically with progressive severity of gastric lesions, with the highest hazard ratio of 10.9 (dysplasia versus normal mucosa, 95% confidence interval 7.7 to 15.4). The increased incidence was stable throughout the follow-up period, and the gaps between cumulative incidence curves grew continuously.

conclusionsAmong patients who undergo gastroscopy with biopsy for clinical indications, approximately 1 in 256 with normal mucosa, 1 in 85 with gastritis, 1 in 50 with atrophic gastritis, 1 in 39 with intestinal metaplasia, and 1 in 19 with dysplasia will develop gastric cancer within 20 years. These numbers, along with cost-benefit analyses, should guide future surveillance policies for these particular patient groups.

Indexed as

AdultAgedAged, 80 and overBiopsyFemaleFollow-Up StudiesGastric MucosaGastroscopyHumansIncidenceMaleMiddle AgedPrecancerous ConditionsProportional Hazards ModelsProspective StudiesRisk

Identifiers

PMID26215280
PMCPMC4516137
OpenAlexW2156623971

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.