A Model for Gastric Cancer Epidemiology

Correa, Pelayo; Haenszel, William; Cuello, Carlos; Tannenbaum, Steven; Archer, Michael C.

doi:10.1016/s0140-6736(75)90498-5

Cited by 1,036 publications

(566 citation statements)

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“…nitrosamines present in foods or formed out of nitrite in cured meat. This seems to support the hypothesis that salt and nitrite are involved in an early stage of gastric carcinogenesis [1,58].…”

Section: Discussionsupporting

confidence: 87%

Untitled

Brandt

Botterweck

Goldbohm

2003

Cancer Causes and Control

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Objective: Many case-control studies have reported that salt and cured meat intake are positively, and refrigerator use is inversely, associated with stomach cancer risk. In the current prospective study these associations were evaluated. Methods: The Netherlands Cohort Study consisted of 120,852 men and women ages 55-69 years at baseline in 1986. Salt exposure was measured by calculating mean daily sodium intake (dietary salt) from 150 food items and by specific salt questions. After 6.3 years of follow-up, 282 incident stomach cancer cases were available for analyses. Case-cohort analyses were based on the 282 cases and 3123 subcohort members. Results: In multivariate analyses adjusted for age, sex, smoking, education, stomach disorders, history of stomach cancer in the family, rate ratios (RR) for increasing quintiles of energy-adjusted intake of dietary salt were 1.00, 1.49, 1.03, 1.54 and 1.18, respectively (p trend ¼ 0.43). An inverse association was found between stomach cancer and salt added at the hot meal (p trend ¼ 0.04). For salt added to home-made soup, use of salt at the table, salt preference and duration of refrigerator use, no associations were observed. Positive associations were found for bacon (RR highest/lowest intake ¼ 1.33; 95% CI ¼ 1.03-1.71) and other sliced cold meat (RR highest/lowest intake ¼ 1.29; 95% CI ¼ 0.96-1.72), but not for smoked sausage, total cold meats, rashers/bacon, boiled ham and smoked beef/pork loin roll. Separate analyses among subjects with self-reported stomach disorders revealed higher RR of stomach cancer for dietary salt and several types of cured meat. Conclusion: The present findings suggest that intake of dietary salt and several types of cured meat were weakly positively associated with stomach cancer risk.Abbreviations: CI -confidence interval; RR -rate ratio

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Section: Discussionsupporting

confidence: 87%

Untitled

Brandt

Botterweck

Goldbohm

2003

Cancer Causes and Control

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“…While the low number of cancers identified in this study makes it impossible to evaluate an association between genotype and cancer, it was possible to evaluate the association with intermediates in the cascade towards cancer. The progression from normal tissue to cancerous tissue is thought to be a change from acute gastritis to chronic gastritis to IM to cancer [44,45]. The association seen here, between cagPAI and both IM and moderate–severe acute antral gastritis, agrees with previous reports that have shown an intact element is related to more severe disease [7,11,12,21,46–48].…”

Section: Discussionsupporting

confidence: 90%

H. pylori-associated pathologic findings among Alaska native patients

Nolen

Bruden

Miernyk

et al. 2018

International Journal of Circumpolar Health

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Helicobacter pylori infection is common among Alaska native (AN) people, however scant gastric histopathologic data is available for this population. This study aimed to characterise gastric histopathology and H. pylori infection among AN people. We enrolled AN adults undergoing upper endoscopy. Gastric biopsy samples were evaluated for pathologic changes, the presence of H. pylori, and the presence of cag pathogenicity island-positive bacteria. Of 432 persons; two persons were diagnosed with gastric adenocarcinoma, two with MALT lymphoma, 40 (10%) with ulcers, and 51 (12%) with intestinal metaplasia. Fifty-five per cent of H. pylori-positive persons had cag pathogenicity island positive bacteria. The gastric antrum had the highest prevalence of acute and chronic moderate–severe gastritis. H. pylori-positive persons were 16 and four times more likely to have moderate–severe acute gastritis and chronic gastritis (p < 0.01), respectively. An intact cag pathogenicity island positive was correlated with moderate–severe acute antral gastritis (53% vs. 31%, p = 0.0003). H. pylori-positive persons were more likely to have moderate–severe acute and chronic gastritis compared to H. pylori-negative persons. Gastritis and intestinal metaplasia were most frequently found in the gastric antrum. Intact cag pathogenicity island positive was correlated with acute antral gastritis and intestinal metaplasia.

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“…The possibility was considered that excluding men with a history of gastric surgery may have introduced some bias into the area comparisons, more having been omitted in Caerphilly than in Bath. If it is assumed that none of these men had severe atrophic gastritis, the prevalence of this condition falls to 7.5%, 13.6%, and 11 .8% respectively in Bath, Caerphilly and Caerphilly adjusted for social class, the two Caerphilly rates (Correa et al, 1975 (Siurala et al, 1968), and that severe atrophic gastritis is associated prospectively with a four to six fold increase in the risk of stomach cancer (Svendsen et al, 1986). If (Varis et al, 1979).…”

Section: Resultsmentioning

confidence: 99%

“…There was, however, no direct relationship between ascorbate concentration and the presence of severe atrophic gastritis. These findings are consistent with the hypothesis that risk of stomach cancer is determined in two stages -a long-term effect, producing atrophic gastritis; and a short-term effect in which vitamin C is protective.It has been suggested that the pathogenesis of stomach cancer involves two stages (Correa et al, 1975). Firstly, there seems to be a long-term effect, possibly initiated in childhood, and leading to severe atrophic gastritis and intestinal metaplasia in the gastric mucosa.…”

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confidence: 99%

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Atrophic gastritis and vitamin C status in two towns with different stomach cancer death-rates

Burr

Samloff²,

Bates³

et al. 1987

Br J Cancer

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Summary A survey was conducted of 513 men aged 65-74 years living in two British towns with high and low stomach cancer death-rates. The prevalence of severe atrophic gastritis (defined as a serum pepsinogen I <20pg I) was significantly higher in the high-risk than in the low-risk town (14.5% and 7.7% respectively); it also tended to be higher in the manual workers, who are known to have a greater risk of stomach cancer than non-manual workers. The manual workers in the high-risk town were particularly likely to have had a partial gastrectomy. Plasma ascorbate concentration and fruit intake were lower in the high-risk area and lower social classes, suggesting a poorer vitamin C status. There was, however, no direct relationship between ascorbate concentration and the presence of severe atrophic gastritis. These findings are consistent with the hypothesis that risk of stomach cancer is determined in two stages -a long-term effect, producing atrophic gastritis; and a short-term effect in which vitamin C is protective.It has been suggested that the pathogenesis of stomach cancer involves two stages (Correa et al., 1975). Firstly, there seems to be a long-term effect, possibly initiated in childhood, and leading to severe atrophic gastritis and intestinal metaplasia in the gastric mucosa. Secondly, carcinogenesis occurs in some stomachs which have undergone these mucosal changes. Fresh fruit and vegetables seem to protect against this effect, possibly because of their vitamin C content. If this sequence is correct, populations with a high risk of stomach cancer should have a higher prevalence of severe atrophic gastritis and a lower vitamin C status than others.Stomach cancer death rates show wide geographical variations. Even within the United Kingdom there are substantial local differences, death rates being substantially higher in Wales than in much of Southern England. There is also a marked social class gradient in the disease; for men aged 15-64 years the standardized mortality ratio (SMR) rises steadily from 50 in social class I (professional people) to 147 in social class V (unskilled manual workers) (Office of Population Censuses and Surveys, 1978).A survey was therefore designed to discover whether the geographical and social-class differences in stomach cancer mortality are reflected by similar differences in vitamin C status (as represented by plasma ascorbate concentration) and the prevalence of severe atrophic gastritis. Diagnosis of severe atrophic gastritis was based on serum pepsinogen (PG), which exists in two forms, PG I and PG II (Samloff et al., 1982). Chronic atrophic gastritis and intestinal metaplasia are characterised by a low serum PG I (below 20 pg 1-) due to a preferential loss of the fundal chief cells which produce this enzyme. A low PG I correlates very well with the degree of severity of gastritis, pernicious anaemia (Samloff et at., 1982), achlorhydria (Levine & Beer, 1984), and the risk of subsequent stomach cancer (Nomura et at., 1980). Subjects and methodsIn view of the steep rise...

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A Model for Gastric Cancer Epidemiology

Cited by 1,036 publications

References 5 publications

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H. pylori-associated pathologic findings among Alaska native patients

Atrophic gastritis and vitamin C status in two towns with different stomach cancer death-rates

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