OLGIM staging and proton pump inhibitor use predict the risk of gastric cancer.

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 …