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The aim of this analysis was to estimate the incidence of CAG in a large population\u2010based study among older adults from Germany and to identify major risk factors associated with its development. In the baseline and 5\u2010year follow\u2010up examinations of the ESTHER study, serological measurements of pepsinogen (PG) I and II and <jats:italic>Helicobacter pylori<\/jats:italic> antibodies were performed in 5,229 women and men, aged 50\u201374 years at baseline. Information on additional potential risk factors was obtained by questionnaire. CAG was defined by PGI &lt; 70 ng\/mL and PGI\/PGII &lt; 3. In total, there were 58 (1.1%) incident CAG cases. CAG incidence increased with increasing age from 0.5% in age group 50\u201354 years to 2.1% in age group 70\u201374 years. Seropositivity with <jats:italic>H. pylori<\/jats:italic> was strongly associated with CAG incidence, with adjusted odds ratios of 5.0 [95% confidence interval (CI): 1.6\u201315.8] and 11.3 (95% CI: 4.2\u201330.0) for participants with cytotoxin associated gene A (cagA) negative and cagA positive <jats:italic>H. pylori<\/jats:italic> infection at both baseline and follow\u2010up compared to those without <jats:italic>H. pylori<\/jats:italic> infection, respectively. Gender, education, smoking, alcohol consumption and family history of gastric cancer were not significantly associated with CAG incidence. Incidence of CAG is rather low in the German population. Older age and infection with <jats:italic>H. pylori<\/jats:italic> are key risk factors for the development of CAG.<\/jats:p>","DOI":"10.1002\/ijc.25476","type":"journal-article","created":{"date-parts":[[2010,5,27]],"date-time":"2010-05-27T02:36:24Z","timestamp":1274927784000},"page":"1652-1658","source":"Crossref","is-referenced-by-count":58,"title":["Incidence and risk factors for the development of chronic atrophic gastritis: Five year follow\u2010up of a population\u2010based cohort study"],"prefix":"10.1002","volume":"128","author":[{"given":"Mariam Abdullahi","family":"Adamu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie 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