The aim of this case-control study, conducted in Serbia during the period 1998-2000, was to investigate whether diet was associated with the development of gastric cancer. The case group consisted of 131 patients with histologically confirmed gastric cancer, and the control group of 131 patients with orthopedics diseases and injuries. Cases and controls were individually matched by age (+/- 2 years), gender, and place of residence. On the basis of multivariate logistic regression analysis, following factors were found as independent risk factors for gastric cancer: more frequent consumption of high-fat milk [Odds ratio (OR) = 1.45, 95% confidence interval (CI) = 0.99-2.16]; mutton, lamb and/or calf meat (OR = 2.46, 95% CI = 1.11-5.47), sugar (OR = 2.13, 95% CI = 1.43-3.18), semi-white bread (OR = 2.09, 95% CI = 1.25-3.50), and salting food (OR = 5.72, 95% CI = 2.63-12.42). Factors found as protective were: more frequent consumption of margarine (OR = 0.41, 95% CI = 0.25-0.69), "other" cheeses (OR = 0.47, 95% CI = 0.29-0.77), and fish (OR = 0.39, 95% CI = 0.19-0.76).

As a result of changes in diet, the incidence of gastric cancer has decreased in most countries. Nowdays, consumption of fresh vegetables and fruits is increasing in regard to canned food. In addition to unhealthy diet, the main risk factors for gastric cancer are H. pylori infection, alcohol consumption, smoking, gastritis, stomach ulcer, gastrectomy, stomach polyposis, positive family history for gastric cancer, pernicious anemia and blood type A. Diet rich in vegetables and fruits, and reduced salt intake can prevent 65-75% of gastric cancer cases among nonsmokers. Prevention of Helicobacter pylori infection can also reduce the incidence of this malignant disease.

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