Objective: This study aimed at evaluating the efficacy of the questionnaire-based prediction model in an independent prospective cohort.Methods: A cluster-randomized controlled trial was conducted in Changsha,Harbin,Luoshan,and Sheyang in eastern China in 2015-2017.A total of 182 villages/communities were regarded as dusters,and allocated to screening arm or control arm randomly.Face-to-face interview through a questionnaire interview,including of relevant risk factors of gastric cancer,was administered for each subject.Participants were further classified into high-risk or low-risk groups based on their exposure to risk factors.All participants were followed up until December 31,2019.Cumulative incidence rates from gastric cancer between high-risk and low-risk groups were calculated and compared using the log-rank test.Cox proportional hazard regression models were applied to estimate hazard ratio (HR) and 95％ confidence interval (95％ CI).Results: Totally,89,914 residents were recruited with a mean follow-up of 3.47 years.And 42,015 (46.73％) individuals were classified into high-risk group and 47,899 (53.27％) subjects were categorized into low-risk group.Gastric cancer was diagnosed in 131 participants,of which 91 were in high-risk group.Compared with the low-risk participants,high-risk individuals were more likely to develop gastric cancer (adjusted HR=2.15,95％ CI,1.23-3.76).The sensitivity of the questionnaire-based model was estimated at 61.82％ (95％ CI,47.71-74.28) in a general population.Coneluslons: Our questionnaire-based model is effective at identifying high-risk individuals for gastric cancer.