Inclusion Criteria:  18 years and over who have been diagnosed or suspected of having pre-malignant gastric conditions: chronic gastritis, atrophic gastritis, intestinal metaplasia or intestinal dysplasia diagnosed with premalignant conditions during the last 5 year (2015-2020) or recently diagnosed eligible patients who have been diagnosed or suspected of having pre-malignant gastric conditions and are scheduled for endoscopy.  Exclusion Criteria:  We will not include children (anyone under the age of 18), individuals unable to consent, pregnant women, or prisoners.