{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:57Z","timestamp":1787014077412,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>A potential association between esophageal squamous cell carcinoma (ESCC) and gastric atrophy (GA) has been reported. However, most published studies have used case\u2013control designs, leading to selection bias. This study aimed to investigate the causal association between ESCC and GA using a nationwide cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted on consecutive participants who underwent endoscopy at 17 health check\u2010up institutes in Japan between 2013 and 2017, with at least one follow\u2010up endoscopy by December 2022. GA was evaluated endoscopically and classified into atrophy\u2010free, closed\u2010type, and open\u2010type GA. The association between ESCC incidence and GA was estimated using the Kaplan\u2013Meier method and Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 33,461 participants, 17,398 (52.0%), 8257 (24.7%), and 7804 (23.3%) were classified into atrophy\u2010free, closed\u2010type GA, and open\u2010type GA, respectively. Seventy\u2010seven ESCCs were identified during a median 6\u2010year follow\u2010up period. The incidence of ESCC was 24 cases (0.024%\/year) in the atrophy\u2010free group, 15 cases (0.031%\/year) in the closed\u2010type GA group, and 38 cases (0.089%\/year) in the open\u2010type GA group, with a significantly higher incidence observed in the open\u2010type GA group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). After adjusting for established risk factors (e.g., age, sex, drinking, and smoking), open\u2010type GA, but not closed\u2010type GA, was an independent risk factor for ESCC (adjusted hazard ratio: 2.72, 95% confidence interval: 1.58\u20134.69).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This Japanese nationwide cohort study provides new evidence suggesting a causal association between extensive GA and the subsequent development of ESCC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.70019","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T07:07:34Z","timestamp":1756192054000},"page":"1332-1339","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Potentially Causal Associations Between Extensive Gastric Atrophy and Esophageal Squamous Cell Carcinoma: A\u00a0Nationwide Retrospective Cohort Study in Japan"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7301-1307","authenticated-orcid":false,"given":"Kenta","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sho","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dai","family":"Kubota","sequence":"additional","affiliation":[{"name":"Next\u2010Generation Endoscopic Computer Vision, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutake","family":"Yamamichi","sequence":"additional","affiliation":[{"name":"Center for Epidemiology and Preventive Medicine The University of Tokyo Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kameda Medical Center Makuhari  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4331-2528","authenticated-orcid":false,"given":"Kyoichi","family":"Adachi","sequence":"additional","affiliation":[{"name":"Health Center, Shimane Environment and Health Public Corporation  Matsue 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