Do subjects with mild or moderate atrophic gastritis or intestinal metaplasia confined to the antrum benefit from gastric cancer surveillance?

We read with interest the paper by Rugge et al which reported that Operative Link on Gastritis Assessment (OLGA) staging reliably predicted the risk for development of gastric epithelial neoplasia.1 No neoplastic lesions were found in low-risk OLGA stages (ie, stages 0–II) where they developed exclusively in high-risk stages (ie, stages III–IV) when followed for 55 months. This study also showed that Helicobacter pylori eradication in subjects with high-risk OLGA stages did not abolish the risk for neoplastic progression. These results are quite convincing. However, two concerns would be raised. First, whether endoscopy surveillance …