Gastric Cancer Risk in Association with Underweight, Overweight, and Obesity: A Systematic Review and Meta-Analysis

Abstract

This study aimed to investigate the risk of gastric cancer (GC) in abnormal body mass index (BMI) groups. A systematic search was carried out on Embase, PubMed/Medline, and Scopus from January 2000 to January 2023. The pooled risk ratio (RR) with a 95% confidence interval (CI) was assessed using a random-effect model. Thirteen studies with total of 14,020,031 participants were included in this systematic review. The pooled RR of GC was 1.124 (95% CI, 0.968–1.304, I2: 89.08%) in underweight class, 1.155 (95% CI, 1.051–1.270, I2: 95.18%) in overweight class, and in 1.218 (95% CI, 1.070–1.386, I2: 97.65%) obesity class. There is no difference between cardia and non-cardia gastric cancer, while non-Asian race and female gender have higher risk of cancer, as Meta-regression of obesity and overweight classes showed. These findings suggest that there is a positive association between excess body weight and the risk of GC, with a higher impact in women than men and in non-Asian than Asian populations. Since abnormal weight is tied to various diseases, including GC, healthcare experts, and policymakers should continue interventions aiming to achieve a normal BMI range.

Risk Factors of Gastric Cancer and Lifestyle Modification for Prevention

“…Nonlinear dose-response meta-analyses have indicated that the risk of distal esophageal cancer significantly increases when BMI exceeds 26 kg/m 2 using a reference point of 21.7 kg/m 2 . In the meta-analysis, the association between obesity and gastric cancer was more pronounced in cardia gastric cancer compared to that in non-cardia gastric cancer [ 11 33 ].…”

The causal association between obesity and gastric cancer and shared molecular signatures: a large-scale Mendelian randomization and multi-omics analysis

“…In the past few years, systematic reviews addressing the BMI-gastric cancer link have yielded inconsistent results (16,17). A meta-analysis published in 2023 suggested a positive association between excess body weight and the risk of gastric cancer (18). However, it remains uncertain whether the observed association reflects a direct causal effect of BMI on gastric carcinogenesis, or stems from confounding or biases inherent in conventional epidemiological studies.…”