I am a 56 y/o white man who is otherwise in good health. I have a history of H. pylori infection and gastritis treated successfully in late 1990s. I have not had any recurrences and have been largely asymptomatic. My only medical condition is hypercholesterolemia for which I take Lipitor 20 mg daily. I do not routinely take any other medications, and I do not routinely use NSAIDs. I do not smoke or drink alcohol, but I am a bit overweight. I had a colonoscopy done recently, which was completely normal. Given my GI history, I requested an EGD, which was done concurrently. The EGD showed mild esophagitis and mild gastritis. I was started on a 30-day course of omeprazole 40 mg daily. Biopsy specimens showed the following histology: 1. Gastroesophageal junction: squamous mucosa with mild irritation changes consistent with reflux esophagitis (no glandular mucosa identified) 2. Gastric fundus and stomach body: superficial mild chronic inflammation with vascular congestion (negative for H. pylori, atrophy, metaplasia, and dysplasia) 3. Gastric incisura: patchy mild chronic gastritis with foveolar hyperplasia, edema, and congestion (negative for H. pylori, atrophy, metaplasia, and dysplasia) 4. Duodenum, bulb and 2nd portion: patchy mild chronic duodenitis with vascular congestion and foveolar metaplasia suggestive of peptic disease (negative for parasites; negative for histologic features of celiac sprue) Given these findings, I have the following questions: 1. Am I at higher risk for stomach cancer, and should I have more frequent GI follow-up and monitoring? If so, what type of monitoring would you recommend, and how frequently should it be done? 2. Are any of the histologic changes (particularly the foveolar metaplasia) considered precancerous? I did a quick review of the literature but found the information a bit confusing. I looked specifically for information on foveolar metaplasia, but most of what I read talked about intestinal metaplasia. I would appreciate learning more about these histologic changes and their clinical implications.