Study population

The Singapore Gastric Cancer Epidemiology and Molecular Genetics Programme (GCEP) is a prospective, multicentre cohort study. Singapore is a country with intermediate incidence of GC, where the incidence of GC is 18.6 and 12.3 per 100 000 population for men and women, respectively.¹⁶ Participants were recruited from four major public hospitals in Singapore, which together provided 80% of the hospitalisation and specialist services in Singapore. Participants were eligible if: (i) they were of Chinese ethnicity; (ii) aged 50 years and above or (iii) had history of H. pylori (HP) infection and/or known premalignant gastric lesions such as atrophic gastritis and IM. Chinese individuals were selected because they have a higher incidence of GC than Malays or Indians in Singapore, where the age-standardised incidence is 25.7, 8.4, 6.6 per 100 000 population in Chinese, Indian and Malay men, respectively.^{5 17} Exclusion criteria for this study included any severe acute or chronic medical, psychiatric condition or laboratory abnormality that may suggest the participant had an increased risk of undergoing routine endoscopy.