Abstract A total of 322 cases of gastric cancer from the surgical material of the Pathology departments of three cities in Colombia and of Mexico City were divided according to the histologic classification of Laurén into two main histologic types: intestinal and diffuse. The intestinal type was predominant in high‐risk areas for stomach cancer, while the diffuse type was more frequent in the low‐risk areas. Data presented suggest that these two main histologic types may be connected with different precancerous lesions as a significant proportion of the intestinal type carcinomas arose from intestinal metaplasia of the gastric mucosa, while the diffuse type showed no such origin. The significance of these findings in relation to the genesis of stomach cancer is discussed.