Which of the following conditions is considered to increase the risk of gastric cancer?

a. Pernicious anemia

b. Prior partial gastrectomy

d. Gastric adenomatous polyps

The risk of developing gastric cancer is greater in stomachs that harbor adenomatous polyps. The risk of developing cancer has been estimated at 10% to 20% and is greatest for polyps more than 2 cm in diameter. Hyperplastic polyps, while common in the normal population, do not have malignant potential. Gastric malignancy is increased in individuals with chronic gastritis associated with pernicious anemia. When pernicious anemia has been present for 5 years, the risk of gastric malignancy is twice that of age-matched controls. An increased risk of gastric carcinoids also exists in patients with pernicious anemia, presumably due to the effects of long-standing hypergastrinemia. A 3-fold increased risk of gastric cancer also exists in patients that have previously undergone partial gastric resection. Postgastrectomy cancer is a long-term concern with increased incidence of malignancy not observed until 15 years postoperatively.