Comparison to other studies
To the best of our knowledge, this is the largest follow-up study to date among patients with gastric precancerous mucosal lesions—both for sample size and length of follow-up. The structure of Swedish healthcare essentially enabled us to include all patients with gastric biopsy. Multiple precise linkages to largely complete high quality national registers—using the national registration numbers as unique identifiers—permitted complete follow-up for cancer outcomes as well as for censoring events. The findings for atrophic gastritis and intestinal metaplasia are principally in agreement with those in another similar large scale follow-up study from Holland8 and thus should be generalisable at least to patients undergoing endoscopy in north western Europe. The incidence that we observed among patients with dysplasia, however, was only a fraction of that reported in the Dutch study.