In a previous endoscopic follow-up examination of patients who 22-30 years before had undergone Billroth II resection for duodenal ulcer the prevalence of dysplasia and carcinoma of the gastric remnant was 14.8 and 0%, respectively. In this second follow-up study five years later the figures had increased to 30.3 and 5.6%. It is uncertain whether these changes result from the higher number of biopsies taken at the re-examination or reflect a time-dependent rise in the morbidity. Although the observed prevalences may seem high, we do not find prophylactic endoscopic examination of such patients indicated, as other investigations by us have shown that the series of Billroth II resected patients under study does not show excess incidence or excess mortality of gastric carcinoma.