Fifth, we did not evaluate other associations with the development of MSGENs such as genetic predispositions (e.g., CDH-1 gene mutation in hereditary diffuse gastric cancer and APC exon 1B mutations in gastric adenocarcinoma and proximal polyposis) and dietary factors (nitrate or nitrite, pickled vegetables, and salted fish), and comorbidities (e.g., asbestos and EBV infection) [43]. Here, CDH1 is linked to gastric adenocarcinoma.