Dietary risk factors in intestinal and diffuse types of stomach cancer: a multicenter case-control study in Poland

Boeing, Heiner; Jędrychowski, Wiesław; Wahrendorf, Jürgen; Popiela, T; Tobiasz–Adamczyk, Beata; Kulig, Andrzej

doi:10.1007/bf00052138

Cited by 103 publications

(50 citation statements)

References 18 publications

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“…Of the previous studies, all of them case -control, that have considered GC pathology in relation to dietary carotenoids, some have failed to detect any associations or differences by subtype (Boeing et al, 1991;Buiatti et al, 1991), whereas others have shown mixed results (Gonzalez et al, 1994;Harrison et al, 1997;Ekstrom et al, 2000), suggesting that the effects of carotenoids might be similar in both histological subtypes. In the present study, none of the analytes, with the possible exception of a-tocopherol, showed any significant effects by anatomical subsite or histological subtype.…”

Section: Discussionmentioning

confidence: 96%

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

Jenab¹,

Riboli²,

Ferrari³

et al. 2006

Br J Cancer

114

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Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of seven common carotenoids, their total plasma concentration, retinol and a-and g-tocopherol, with the risk of gastric adenocarcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 countries. A secondary objective was to determine the association of total sum of carotenoids, retinol and a-tocopherol on GCs by anatomical subsite (cardia/noncardia) and histological subtype (diffuse/intestinal). Analytes were measured by high-performance liquid chromatography in prediagnostic plasma from 244 GC cases and 645 controls matched by age, gender, study centre and date of blood donation. Conditional logistic regression models adjusted by body mass index, total energy intake, smoking and Helicobacter pylori infection status were used to estimate relative cancer risks. After an average 3.2 years of follow-up, a negative association with GC risk was observed in the highest vs the lowest quartiles of plasma b-cryptoxanthin (odds ratio (OR) ¼ 0.53, 95% confidence intervals (CI) ¼ 0.30-0.94, P trend ¼ 0.006), zeaxanthin (OR ¼ 0.39, 95% CI ¼ 0.22-0.69, P trend ¼ 0.005), retinol (OR ¼ 0.55, 95% CI ¼ 0.33-0.93, P trend ¼ 0.005) and lipid-unadjusted a-tocopherol (OR ¼ 0.59, 95% CI ¼ 0.37-0.94, P trend ¼ 0.022). For all analytes, no heterogeneity of risk estimates or significant associations were observed by anatomical subsite. In the diffuse histological subtype, an inverse association was observed with the highest vs lowest quartile of lipid-unadjusted a-tocopherol (OR ¼ 0.26, 95% CI ¼ 0.11-0.65, P trend ¼ 0.003). These results show that higher plasma concentrations of some carotenoids, retinol and a-tocopherol are associated with reduced risk of GC.

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Section: Discussionmentioning

confidence: 96%

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

Jenab¹,

Riboli²,

Ferrari³

et al. 2006

Br J Cancer

114

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“…19,[35][36][37][38] An earlier pathology investigation in Ardabil had found that 49.5% of GC were diagnosed in cardia. 39 We also found the previously reported association between GC and a positive family history [15][16][17][18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

The role of diet and other environmental factors in the causation of gastric cancer in Iran—A population based study

Pourfarzi

Whelan

Kaldor

et al. 2009

Intl Journal of Cancer

127

107

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Despite a declining trend in the incidence of gastric cancer (GC), it is still a major global public health concern of the 21st century. The rates of GC reported from Ardabil Province, Iran, are among the highest in the world. To investigate risk factors for GC in Ardabil, we undertook a population-based case-control study. The study aimed to recruit all Ardabil residents newly diagnosed with GC in the time period of 2004-2005, and 2 controls per case. Participants were interviewed using a structured questionnaire. Ten milliliters of blood was collected for blood grouping and investigating the presence of IgG antibodies against Helicobacter pylori. During the study period, 217 people with GC and 394 controls were recruited. In multivariate analysis, diet and Helicobacter pylori infection (OR 5 2.41; 95% CI: 1.35-4.32) were found to be the factors that were most strongly related to GC. High intake of Allium vegetables (OR 5 0.35) and fruit, especially citrus fruit (OR 5 0.31) and consumption of fresh fish (OR 5 0.37) were significantly protective. On the other hand, consumption of red meat (OR 5 3.40) and dairy products (OR 5 2.28) were positively associated with the risk of GC. People who had a preference for higher salt intake (OR 5 3.10) and drinking strong and hot tea (OR 5 2.64 and 2.85, respectively) were at higher risk. In conclusion, Helicobacter pylori infection as measured by serum IgG as well as the consumption of red meat and dairy products increases the risk of GC in Ardabil, while the intake of fresh fruit and fresh fish decrease the risk. ' 2009 UICC

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“…Among case-control studies, 5 studies [22][23][24][25][26] have found a 2-to 3-fold statistically significant increase in stomach cancer risk associated with high consumption of processed meat, 6 studies 27-32 have observed a 30-70% increased risk but the results were not statistically significant, and 2 studies did not support an association. 33,34 In some case-control studies, positive associations were found for specific processed meat items, including bacon, 35,36 sausage 35,37,38 or ham. 35,39 The evidence from prospective cohort studies is less supportive of an association between processed meat consumption and risk of stomach cancer.…”

Section: Discussionmentioning

confidence: 99%

Processed meat consumption, dietary nitrosamines and stomach cancer risk in a cohort of Swedish women

Larsson

Bergkvist²,

Wolk

2006

Intl Journal of Cancer

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Processed meat consumption has been associated with an increased risk of stomach cancer in some epidemiological studies (mainly case-control). Nitrosamines may be responsible for this association, but few studies have directly examined nitrosamine intake in relation to stomach cancer risk. We prospectively investigated the associations between intakes of processed meat, other meats and N-nitrosodimethylamine (the most frequently occurring nitrosamine in foods) with risk of stomach cancer among 61,433 women who were enrolled in the population-based Swedish Mammography Cohort. Information on diet was collected at baseline (between 1987 and 1990) and updated in 1997. During 18 years of follow-up, 156 incident cases of stomach cancer were ascertained. High consumption of processed meat, but not of other meats (i.e., red meat, fish and poultry), was associated with a statistically significant increased risk of stomach cancer. After adjustment for potential confounders, the hazard ratios for the highest compared with the lowest category of intake were 1.66 (95% CI 5 1.13-2.45) for all processed meats, 1.55 (95% CI 5 1.00-2.41) for bacon or side pork, 1.50 (95% CI 5 0.93-2.41) for sausage or hotdogs and 1.48 (95% CI5 0.99-2.22) for ham or salami. Stomach cancer risk was 2-fold higher among women in the top quintile of N-nitrosodimethylamine intake when compared with those in the bottom quintile (hazard ratio 5 1.96; 95% CI 5 1.08-3.58). Our findings suggest that high consumption of processed meat may increase the risk of stomach cancer. Dietary nitrosamines might be responsible for the positive association. ' 2006 Wiley-Liss, Inc.Key words: cohort studies; diet; gastric cancer; meat; nitrosamines; poultry; prospective studies; stomach cancer Diet is a potentially modifiable exposure that is assumed to play a major role in the etiology of stomach cancer, 1 the second leading cause of cancer-related death worldwide.2 Among dietary factors, high intake of processed meat, which includes meats preserved by salting, smoking or the addition of nitrites or nitrates, might be associated with elevated risk of stomach cancer. In 1997, the World Cancer Research Fund and the American Institute for Cancer Research 1 stated that diets high in processed meat may increase the risk of stomach cancer, but that the evidence was yet insufficient. However, that conclusion was based mainly on casecontrol studies, which are more susceptible to systematic bias than prospective cohort studies, and recent prospective studies have been inconsistent. [3][4][5][6] Besides much salt and nitrites or nitrates, processed meat products like bacon, sausage and ham often contains carcinogenic nitrosamines.7-9 N-nitrosodimethylamine (NDMA) is the most frequently occurring nitrosamine in foods.10 Nitrosamines can also be formed endogenously in the stomach through nitrosation of nitrite with amines.7 To date, 5 case-control studies [11][12][13][14][15] and only 1 prospective cohort study 3 with a small number of cases (n 5 68) have investigated the associat...

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Dietary risk factors in intestinal and diffuse types of stomach cancer: a multicenter case-control study in Poland

Cited by 103 publications

References 18 publications

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

The role of diet and other environmental factors in the causation of gastric cancer in Iran—A population based study

Processed meat consumption, dietary nitrosamines and stomach cancer risk in a cohort of Swedish women

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