Determining Gastric Cancer-Related Risk Factors in Mongolian Population Using ABC(D) Method: A Matched Case-Control Study

Abstract

Objective: We aimed to identify gastric cancer-related risk factors and evaluate the efficacy of screening ABC(D) method in determining high risk gastric cancer individuals in Mongolian population. Methods: A total of 240 participants (120 gastric cancer patients and 120 healthy individuals) were included in this study. Data were collecting using a structured questionnaire consisting of 56 questions covering 5 categories. Serum Helicobacter pylori IgG ( H. pylori IgG), pepsinogen I (PGI), and pepsinogen II (PGII) were tested in one third of all the participants (40 gastric cancer patients and 40 controls). PGI, PGII, and H. pylori IgG levels were measured using GastroPanel enzyme-linked immunosorbent assay kit (Biohit, Helsinki, Finland). Results: Habits of having leftover meals (OR 2.22, 95%CI 1.27-3.86, p<0.01), daily consumption of tea with salt (OR 1.97, 95%CI 1.18-3.30, p<0.01), smoking on an empty stomach (OR 2.44, 95%CI 1.11-5.37, p<0.05), daily consumption of vegetables (OR 0.45, 95%CI 0.27-0.76, p<0.01), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p<0.05), family history of gastric cancer (parents OR 2.88, 95%CI 1.07-7.78, p<0.05, siblings (OR 3.09, 95%CI 1.09-8.81, p<0.05), and history of gastric diseases (OR 3.65, 95%CI 2.10-6.35, p<0.0001) were identified as protective factors. A low PGI level (<35.25ng/ml) and low PGI/II ratio (<4) were associated with gastric cancer risk. According to ABC(D) method, groups C and D had higher proportion of gastric cancer cases than group A and B (group C, OR 7.50, 95%CI 1.20-47.05, p<0.05; group D, OR 8.3, 95%CI 1.33-51.26, p<0.05). Conclusion: Our findings suggested that gastric cancer risk was more closely related to eating habits, smoking, family history, and precancerous lesions. ABC(D) method seems to be a plausible alternative or supplementary method for stratifying patients at high risk of gastric cancer in this country.

Systematic review and meta‐analysis: Risk of gastric cancer in patients with first‐degree relatives with gastric cancer

“…All the studies included in this systematic review indicated that a first‐degree family history of gastric cancer represents a risk factor for gastric cancer 14–43 . The studies included in our systematic review provided interesting insights through subanalyses that explored various factors, such as gender, the type of family member affected (father, mother, or sibling), the specific anatomical site of cancer (corpus/antrum), geographical risk, and age considerations.…”

“…In contrast, only one study described a higher risk in male individuals 38 . Additionally, the presence of siblings affected by gastric cancer was identified as a higher risk factor than a parental history of gastric cancer 17,19,20,21,24,27,29,30,36,37,41 . Furthermore, in many studies, it was documented that having a mother affected by gastric cancer represented a higher risk than having a father affected by gastric cancer 35,39,41 .…”

“…38 Additionally, the presence of siblings affected by gastric cancer was identified as a higher risk factor than a parental history of gastric cancer. 17,19,20,21,24,27,29,30,36,37,41 Furthermore, in many studies, it was documented that having a mother affected by gastric cancer represented a higher risk than having a father affected by gastric cancer. 35,39,41 In one study, the risk of gastric cancer in family history was higher in the intestinal histotype 16 ; conversely, in another study, greater familial risk was documented in the diffuse histotype.…”