This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: All India exam, Subject name: Medicine
Which one of the following is the most significant risk factor for development of gastric carcinoma? 
Select and explain. 
A. Paneth cell metaplasia, B. Pyloric metaplasia, C. Intestinal metaplasia, D. Ciliated metaplasia
C: Intestinal metaplasia
Answer: C: Intestinal metaplasia 
Explanation: Risk factors are:Long-term ingestion of high concentration of nitratesH.pyloriIntestinal metaplasia in patients with atrophic gastritisGastric ulcers and adenomatous polypsMenetrier's diseasePatients with blood group A have a higher incidence of Ca stomach than blood group ONote: duodenal ulcers are not associated with gastric cancer.Ref: Harrison's 18/e p766