Which one of the following is the most significant risk factor for development of gastric carcinoma ?

Ans. is 'c' i.e., Intestinal metaplasia"The risk of tumor development is greatly increased in patients in whom mucosal inflammation progresses to multifocal mucosal atrophy and intestinal metaplasia"- Robbins`Serial endoscopic examinations of the stomach in patients with atrophic gastritis have documented replacement of the usual gastric mucosa by intestinal type cells. This process of intestinal metaplasia may lead to cellular atypia and eventual neoplasia. - HarrisonFactors Associated with Increased incidence of Gastric CarcinomaEnvironmental Factors1. Infection by FL Pylorio Present in most cases of intestinal-type carcinomaDieto Nitrites derived from nitrates (water, preserved food)o Smoked and salted foods, pickled vegetables, chili peppers o Lack of fresh fruit and vegetablesLow socioeconomic statusCigarette smokingGenetic FactorsSlightly increased risk with blood group AFamily history of gastric cancer3. Hereditary nonpolyposis colon cancer syndromeFamilial gastric carcinoma syndrome (E-cadherin mutation)Decreased risk of stomch cancer is seen witho Vitamine C & E o Diet high in green leafy vegetables and citrus fruitso Aspirin o Beta - Carotene