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We conducted a population\u2010based prospective study among 9740 subjects who underwent upper endoscopy screening during 2005 to 2009 and followed until December 2017. Cumulative incidence and mortality rates of GCA were calculated by the baseline histological diagnoses, and the hazard ratios (HRs), overall and by age and sex, were analyzed by Cox proportional hazards models. During a median follow\u2010up of 10\u2009years, we identified 123 new GCA cases (1.26%) and 31 GCA deaths (0.32%). The age\u2010standardized incidence and mortality rates of GCA were 128.71\/100\u2009000 and 35.69\/100\u2009000 person\u2010years, and cumulative incidence rate in patients with cardia high\u2010grade dysplasia (CHGD), cardia low\u2010grade dysplasia (CLGD) and atrophic carditis (AC)\/cardia intestinal metaplasia (CIM) was 25%, 3.05% and 1.58%, respectively. The progression rate and cancer risk of GCA increased monotonically with each step in Correa's cascade. Individuals aged 50 to 69\u2009years had 4.4 times higher GCA incidence than those aged 40 to 49\u2009years. Patients with CLGD had a significantly higher 3\u2010year GCA incidence than the normal group, while patients with AC\/CIM had a comparable GCA risk during 3\u2010year follow\u2010up but a higher risk at 5\u2010year intervals. Our results suggested a postponed starting age of 50\u2009years for GCA screening, immediate treatment for patients with CHGD, a 3\u2010year surveillance interval for patients with CLGD, and a lengthened surveillance interval of 5\u2009years for patients with AC\/CIM.<\/jats:p>","DOI":"10.1002\/ijc.33720","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T13:00:11Z","timestamp":1624885211000},"page":"1639-1648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Surveillance of premalignant gastric cardia lesions: A population\u2010based prospective cohort study in China"],"prefix":"10.1002","volume":"149","author":[{"given":"Jianhua","family":"Gu","sequence":"first","affiliation":[{"name":"Office of National Central Cancer Registry, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1096-9088","authenticated-orcid":false,"given":"Shuanghua","family":"Xie","sequence":"additional","affiliation":[{"name":"Office of National Central Cancer Registry, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0420-2833","authenticated-orcid":false,"given":"Shaoming","family":"Wang","sequence":"additional","affiliation":[{"name":"Office of National Central Cancer Registry, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyan","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiachen","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health, Xi'an Jiaotong University Health Science Center  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjuan","family":"Li","sequence":"additional","affiliation":[{"name":"Office of National Central Cancer Registry, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Office of National Central Cancer Registry, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ru","family":"Chen","sequence":"additional","affiliation":[{"name":"Office of National Central Cancer Registry, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2450-8610","authenticated-orcid":false,"given":"Daniel R. 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