1
|
Gonzalez-Palacios S, Compañ-Gabucio LM, Torres-Collado L, Oncina-Canovas A, García-de-la-Hera M, Collatuzzo G, Negri E, Pelucchi C, Rota M, López-Carrillo L, Lunet N, Morais S, Ward MH, Martin V, Lozano-Lorca M, Malekzadeh R, Pakseresht M, Hernández-Ramírez RU, Bonzi R, Patel L, López-Cervantes M, Rabkin CS, Tsugane S, Hidaka A, Trichopoulou A, Karakatsani A, Camargo MC, Curado MP, Zhang ZF, La Vecchia C, Boffetta P, Vioque J. The protective effect of dietary folate intake on gastric cancer is modified by alcohol consumption: A pooled analysis of the StoP Consortium. Int J Cancer 2024; 155:1367-1375. [PMID: 38757245 PMCID: PMC11326987 DOI: 10.1002/ijc.35004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024]
Abstract
Dietary folate intake has been identified as a potentially modifiable factor of gastric cancer (GC) risk, although the evidence is still inconsistent. We evaluate the association between dietary folate intake and the risk of GC as well as the potential modification effect of alcohol consumption. We pooled data for 2829 histologically confirmed GC cases and 8141 controls from 11 case-control studies from the international Stomach Cancer Pooling Consortium. Dietary folate intake was estimated using food frequency questionnaires. We used linear mixed models with random intercepts for each study to calculate adjusted odds ratios (OR) and 95% confidence interval (CI). Higher folate intake was associated with a lower risk of GC, although this association was not observed among participants who consumed >2.0 alcoholic drinks/day. The OR for the highest quartile of folate intake, compared with the lowest quartile, was 0.78 (95% CI, 0.67-0.90, P-trend = 0.0002). The OR per each quartile increment was 0.92 (95% CI, 0.87-0.96) and, per every 100 μg/day of folate intake, was 0.89 (95% CI, 0.84-0.95). There was a significant interaction between folate intake and alcohol consumption (P-interaction = 0.02). The lower risk of GC associated with higher folate intake was not observed in participants who consumed >2.0 drinks per day, ORQ4v Q1 = 1.15 (95% CI, 0.85-1.56), and the OR100 μg/day = 1.02 (95% CI, 0.92-1.15). Our study supports a beneficial effect of folate intake on GC risk, although the consumption of >2.0 alcoholic drinks/day counteracts this beneficial effect.
Collapse
Affiliation(s)
- Sandra Gonzalez-Palacios
- Epidemiología de la Nutrición, Universidad Miguel Hernández (UMH), Alicante, Spain
- Nutritional Epidemiology Research Group, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Group 6, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laura-María Compañ-Gabucio
- Epidemiología de la Nutrición, Universidad Miguel Hernández (UMH), Alicante, Spain
- Nutritional Epidemiology Research Group, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Group 6, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laura Torres-Collado
- Epidemiología de la Nutrición, Universidad Miguel Hernández (UMH), Alicante, Spain
- Nutritional Epidemiology Research Group, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Group 6, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alejandro Oncina-Canovas
- Epidemiología de la Nutrición, Universidad Miguel Hernández (UMH), Alicante, Spain
- Nutritional Epidemiology Research Group, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Group 6, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Manuela García-de-la-Hera
- Epidemiología de la Nutrición, Universidad Miguel Hernández (UMH), Alicante, Spain
- Nutritional Epidemiology Research Group, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Group 6, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Lizbeth López-Carrillo
- Population Health Research Center, Mexico National Institute of Public Health, Morelos, Mexico
| | - Nuno Lunet
- Cancer Epidemiology, EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Samantha Morais
- Cancer Epidemiology, EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Vicente Martin
- Nutritional Epidemiology Research Group, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), Universidad de León, León, Spain
| | - Macarena Lozano-Lorca
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | | | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Linia Patel
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Graduate School of Public Health, International University of Health and Welfare Graduate School of Public Health, Tokyo, Japan
| | - Akihisa Hidaka
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Department of Diabetes and Endocrinology, JCHO Tokyo Yamate Medical Centre, Tokyo, Japan
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, Medical School, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, Haidari, Greece
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
| | - Jesús Vioque
- Epidemiología de la Nutrición, Universidad Miguel Hernández (UMH), Alicante, Spain
- Nutritional Epidemiology Research Group, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Group 6, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| |
Collapse
|
2
|
Pastorino R, Pires Marafon D, Sassano M, Hoxhaj I, Pelucchi C, Liao LM, Rabkin CS, Sinha R, Lunet N, Morais S, Zaridze D, Maximovich D, Aragonés N, Castaño-Vinyals G, Gómez-Acebo I, López-Carrillo L, López-Cervantes M, Bonzi R, Turati F, Boffetta P, Camargo MC, Curado MP, Vioque J, Zhang ZF, Negri E, La Vecchia C, Boccia S. Aspirin but not statins is inversely related to gastric cancer with a duration-risk effect: Results from the Stomach Cancer Pooling Project Consortium. Cancer 2024. [PMID: 39154222 DOI: 10.1002/cncr.35510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/20/2024] [Accepted: 06/12/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Aspirin and statins have been suggested to have potential chemopreventive effects against gastric cancer (GC), although the results of previous studies have been inconsistent. This study therefore aimed to investigate the association between the use of aspirin and statins and GC. METHODS A pooled analysis of seven case-control studies within the Stomach Cancer Pooling Project, including 3220 cases and 9752 controls, was conducted. Two-stage modeling analyses were used to estimate the association between aspirin and statin use and GC after adjusting for potential confounders. RESULTS The pooled odds ratio (OR) of GC for aspirin users versus nonusers was 0.72 (95% confidence interval [CI], 0.54-0.95). The protective effect of aspirin appeared stronger in individuals without a GC family history (OR, 0.60; 95% CI, 0.37-0.95), albeit with borderline heterogeneity between those with and without a family history (p = .064). The OR of GC decreased with increasing duration of aspirin use, with an OR of 0.41 (95% CI, 0.18-0.95) for durations of ≥15 years. An inverse, nonsignificant association with the risk of GC was observed for the use of statins alone (OR, 0.79; 95% CI, 0.52-1.18). CONCLUSIONS These findings suggest that aspirin use, particularly long-term use, is associated with a reduced risk of GC, whereas a similar association was not observed with statins, possibly because of the low frequency of use.
Collapse
Affiliation(s)
- Roberta Pastorino
- Section of Hygiene, University Department of Health Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Denise Pires Marafon
- Section of Hygiene, University Department of Health Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michele Sassano
- Section of Hygiene, University Department of Health Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Ilda Hoxhaj
- Section of Hygiene, University Department of Health Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Nuno Lunet
- Unidade de Investigação em Epidemiologia, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional, Universidade do Porto, Porto, Portugal
- Department of Clinical Epidemiology, N. N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Samantha Morais
- Unidade de Investigação em Epidemiologia, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional, Universidade do Porto, Porto, Portugal
| | - David Zaridze
- Department of Clinical Epidemiology, N. N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Dmitry Maximovich
- Department of Clinical Epidemiology, N. N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Nuria Aragonés
- Cancer Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Barcelona Institute for Global Health, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Inés Gómez-Acebo
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Faculty of Medicine, University of Cantabria, Santander, Spain
- Instituto de Investigación Sanitaria Valdecilla, Santander, Spain
| | | | | | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Federica Turati
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Maria Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez, Alicante, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California, USA
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Health Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| |
Collapse
|
3
|
Collatuzzo G, Cortez Lainez J, Pelucchi C, Negri E, Bonzi R, Palli D, Ferraroni M, Zhang ZF, Yu GP, Lunet N, Morais S, López-Carrillo L, Zaridze D, Maximovitch D, Guevara M, Santos-Sanchez V, Vioque J, Garcia de la Hera M, Ward MH, Malekzadeh R, Pakseresht M, Hernández-Ramírez RU, Turati F, Rabkin CS, Liao LM, Sinha R, López-Cervantes M, Tsugane S, Hidaka A, Camargo MC, Curado MP, Zubair N, Kristjansson D, Shah S, La Vecchia C, Boffetta P. The association between dietary fiber intake and gastric cancer: a pooled analysis of 11 case-control studies. Eur J Nutr 2024; 63:1857-1865. [PMID: 38687390 PMCID: PMC11329417 DOI: 10.1007/s00394-024-03388-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 04/01/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Gastric cancer (GC) is among the leading causes of cancer mortality worldwide. The objective of this study was to investigate the association between dietary fiber intake and GC. METHODS We pooled data from 11 population or hospital-based case-control studies included in the Stomach Cancer Pooling (StoP) Project, for a total of 4865 histologically confirmed cases and 10,626 controls. Intake of dietary fibers and other dietary factors was collected using food frequency questionnaires. We calculated the odds ratios (OR) and 95% confidence intervals (CI) of the association between dietary fiber intake and GC by using a multivariable logistic regression model adjusted for study site, sex, age, caloric intake, smoking, fruit and vegetable intake, and socioeconomic status. We conducted stratified analyses by these factors, as well as GC anatomical site and histological type. RESULTS The OR of GC for an increase of one quartile of fiber intake was 0.91 (95% CI: 0.85, 0.97), that for the highest compared to the lowest quartile of dietary fiber intake was 0.72 (95% CI: 0.59, 0.88). Results were similar irrespective of anatomical site and histological type. CONCLUSION Our analysis supports the hypothesis that dietary fiber intake may exert a protective effect on GC.
Collapse
Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, BO, Italy
| | | | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, BO, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Domenico Palli
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Nuno Lunet
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - David Zaridze
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Marcela Guevara
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Salud Pública y Laboral de Navarra, 31003, Pamplona, Spain
- Navarre Institute for Health Research (IdiSNA), 31008, Pamplona, Spain
| | - Vanessa Santos-Sanchez
- Centro de Investigacion en Recursos Naturales, Salud y Medio Ambiente, Huelva University, Huelva, Spain
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, 46020, Alicante, Spain
| | - Manoli Garcia de la Hera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, 46020, Alicante, Spain
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | | | - Federica Turati
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Shoichiro Tsugane
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo City, Tokyo, Japan
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Nadia Zubair
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Shailja Shah
- Division of Gastroenterology, University of California San Diego, San Diego, CA, USA
- Gastroenterology Section, VA San Diego Healthcare System, San Diego, CA, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, BO, Italy.
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
| |
Collapse
|
4
|
Sassano M, Seyyedsalehi MS, Collatuzzo G, Pelucchi C, Bonzi R, Ferraroni M, Palli D, Yu GP, Zhang ZF, López-Carrillo L, Lunet N, Morais S, Zaridze D, Maximovich D, Martín V, Castano-Vinyals G, Vioque J, González-Palacios S, Ward MH, Malekzadeh R, Pakseresht M, Hernández-Ramirez RU, López-Cervantes M, Negri E, Turati F, Rabkin CS, Tsugane S, Hidaka A, Lagiou A, Lagiou P, Camargo MC, Curado MP, Boccia S, La Vecchia C, Boffetta P. Dietary intake of vitamin C and gastric cancer: a pooled analysis within the Stomach cancer Pooling (StoP) Project. Gastric Cancer 2024; 27:461-472. [PMID: 38436761 PMCID: PMC11016516 DOI: 10.1007/s10120-024-01476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Previous studies suggest that dietary vitamin C is inversely associated with gastric cancer (GC), but most of them did not consider intake of fruit and vegetables. Thus, we aimed to evaluate this association within the Stomach cancer Pooling (StoP) Project, a consortium of epidemiological studies on GC. METHODS Fourteen case-control studies were included in the analysis (5362 cases, 11,497 controls). We estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the association between dietary intake of vitamin C and GC, adjusted for relevant confounders and for intake of fruit and vegetables. The dose-response relationship was evaluated using mixed-effects logistic models with second-order fractional polynomials. RESULTS Individuals in the highest quartile of dietary vitamin C intake had reduced odds of GC compared with those in the lowest quartile (OR: 0.64; 95% CI: 0.58, 0.72). Additional adjustment for fruit and vegetables intake led to an OR of 0.85 (95% CI: 0.73, 0.98). A significant inverse association was observed for noncardia GC, as well as for both intestinal and diffuse types of the disease. The results of the dose-response analysis showed decreasing ORs of GC up to 150-200 mg/day of vitamin C (OR: 0.54; 95% CI: 0.41, 0.71), whereas ORs for higher intakes were close to 1.0. CONCLUSIONS The findings of our pooled study suggest that vitamin C is inversely associated with GC, with a potentially beneficial effect also for intakes above the currently recommended daily intake (90 mg for men and 75 mg for women).
Collapse
Affiliation(s)
- Michele Sassano
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Monireh Sadat Seyyedsalehi
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Beijing, China
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | - Nuno Lunet
- EPIUnit, Instituto de Saúde Pública da Universidade Do Porto, Porto, Portugal
- Laboratório Para a Investigação Integrativa E Translacional Em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública E Forenses E Educação Médica, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit, Instituto de Saúde Pública da Universidade Do Porto, Porto, Portugal
- Laboratório Para a Investigação Integrativa E Translacional Em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública E Forenses E Educação Médica, Faculdade de Medicina, Universidade Do Porto, Porto, Portugal
| | - David Zaridze
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Dmitry Maximovich
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Vicente Martín
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Biomedicina, Universidad de León, León, Spain
| | - Gemma Castano-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Barcelona Institute for Global Health-ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jesús Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain
| | - Sandra González-Palacios
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | | | | | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Federica Turati
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- International University of Health and Welfare Graduate School of Public Health, Tokyo, Japan
| | - Akihisa Hidaka
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Department of Diabetes and Endocrinology, JCHO Tokyo Yamate Medical Centre, Tokyo, Japan
| | - Areti Lagiou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brasil
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
- Stony Brook Cancer Center, Stony Brooke University, Stony Brook, NY, USA.
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
| |
Collapse
|
5
|
Patel L, La Vecchia C, Negri E, Mignozzi S, Augustin LSA, Levi F, Serraino D, Giacosa A, Alicandro G. Legume intake and cancer risk in a network of case-control studies. Eur J Clin Nutr 2024:10.1038/s41430-024-01408-w. [PMID: 38321187 DOI: 10.1038/s41430-024-01408-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024]
Abstract
Evidence on the relationship between legume consumption and risk of specific cancer sites is inconclusive. We used data from a series of case-controls studies, conducted in Italy and in the Swiss Canton of Vaud between 1991 and 2009 to quantify the association between legume consumption and several cancer sites including oral cavity, esophagus, larynx, stomach, colorectum, breast, endometrium, ovary, prostate and kidney. Multiple logistic regression models controlled for sex, age, education, smoking, alcohol, body mass index, physical activity, comorbidities, and consumption of fruit, vegetables, processed meat and total calorie intake were used to estimate the odds ratios (OR) for different cancer sites and their corresponding 95% confidence intervals(CI). For female hormone-related cancers, the models also included adjustments for age at menarche, menopausal status and parity. Although most of the estimates were below unity, suggesting a protective effect, only colorectal cancer showed a significant association. Compared to no consumption, the OR for consuming at least one portion of legumes was 0.79 (95% CI: 0.68-0.91), the OR for consuming two or more portions was 0.68 (95% CI: 0.57-0.82) and the estimate for an increment of one portion per week was 0.87 (95% CI: 0.81-0.93). The inverse association between legume consumption and colorectal cancer suggests a possible role of legumes in preventing cancer risk.
Collapse
Affiliation(s)
- Linia Patel
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Silvia Mignozzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Livia S A Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS "Fondazione G.Pascale", Naples, Italy
| | - Fabio Levi
- Department of Epidemiology and Health Services Research, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Attilio Giacosa
- Department of Gastroenterology and Clinical Nutrition, Policlinico di Monza, Monza, Italy
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
- Paediatric Department, Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| |
Collapse
|
6
|
Turati F, Concina F, Bertuccio P, Fiori F, Parpinel M, Garavello W, Crispo A, Libra M, Negri E, Serraino D, La Vecchia C. Prebiotics and the Risk of Upper Digestive Tract and Stomach Cancers: The PrebiotiCa Study. J Acad Nutr Diet 2023; 123:1772-1780. [PMID: 37468063 DOI: 10.1016/j.jand.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Fiber intake may lower digestive tract cancer risk, possibly by modulating the composition of gut microbiota. However, no data are available about the role of specific fiber fractions with prebiotic activity (e.g., inulin-type fructans (ITFs), fructo-oligosaccharides (FOSs) and galactooligosaccharides (GOSs)) on the risk lower digestive tract cancers. OBJECTIVE The objective was to assess the association between prebiotic intake and the risk of cancers of the upper digestive tract and stomach. DESIGN Within the PrebiotiCa study, data were derived from a network of Italian case-control studies conducted between 1992 and 2009. Participants' usual diet was assessed using a food frequency questionnaire. ITFs, and selected FOSs (nystose, kestose, and 1F-β-fructofuranosylnystose) and GOSs (raffinose and stachyose) were quantified in several food products via laboratory analyses. Participants' prebiotic intake was calculated by multiplying food frequency questionnaire intake by the prebiotic content of each food item. PARTICIPANTS/SETTING Cases were patients admitted to major hospitals with incident histologically confirmed cancers; there were 946 cases of cancer of the oral cavity/pharynx, 198 of the nasopharynx, 304 of the esophagus, 230 of the stomach. More than 4,000 patients admitted to the same hospitals for acute nonneoplastic and not diet-related conditions were selected as control subjects. MAIN OUTCOME MEASURES The outcomes were oral and pharyngeal, nasopharyngeal, esophageal, and stomach cancers. STATISTICAL ANALYSES PERFORMED The odds ratios and corresponding 95% CIs of the various cancers were derived using logistic regression models adjusted for major confounders and energy intake. RESULTS No association was observed between intake of prebiotics and risk of cancers of the oral cavity and pharynx, nasopharynx, and esophagus. High raffinose intake reduced stomach cancer risk (odds ratio for the third vs the first tertile 0.6, 95% CI 0.3 to 0.9); no other prebiotic was associated with stomach cancer. CONCLUSIONS The current study does not support a major role of prebiotic fibers on selected upper digestive tract cancers. The association between high raffinose intake and reduced stomach cancer risk needs further investigation.
Collapse
Affiliation(s)
- Federica Turati
- Branch of Medical Statistics, Biometry, and Epidemiology "G.A. Maccacaro," Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Federica Concina
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo," Trieste, Italy
| | - Paola Bertuccio
- Branch of Medical Statistics, Biometry, and Epidemiology "G.A. Maccacaro," Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Federica Fiori
- Department of Medicine-DAME, University of Udine, Udine, Italy
| | - Maria Parpinel
- Department of Medicine-DAME, University of Udine, Udine, Italy
| | - Werner Garavello
- School of Medicine and Surgery, University of Milano-Bicocca, Italy; Department of Otorhinolaryngology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia
| | - Anna Crispo
- Epidemiology Unit, National Cancer Institute "Pascale Foundation" IRCCS, Naples, Italy
| | - Massimo Libra
- Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Diego Serraino
- Unit of Cancer Epidemiology, CRO National Cancer Institute, IRCCS, Aviano, Italy
| | - Carlo La Vecchia
- Branch of Medical Statistics, Biometry, and Epidemiology "G.A. Maccacaro," Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| |
Collapse
|
7
|
Mariani M, Pastorino R, Pires Marafon D, Johnson KC, Hu J, Molina de la Torre AJ, Fernández-Tardón G, Zaridze D, Maximovich D, Negri E, La Vecchia C, Zhang ZF, Kurtz RC, Pelucchi C, Rota M, Boccia S. Leisure-time physical activity and gastric cancer risk: A pooled study within the Stomach cancer Pooling (StoP) Project. PLoS One 2023; 18:e0286958. [PMID: 37437057 PMCID: PMC10337950 DOI: 10.1371/journal.pone.0286958] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/26/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Although physical activity (PA) has been recognized as a favourable factor in the prevention of various diseases, including certain forms of cancer, the relationship between PA and gastric cancer (GC) is not yet fully understood. This study aims to provide data from a pooled analysis of case-control studies within the Stomach cancer Pooling (StoP) Project to estimate the association between leisure-time PA and the occurrence of GC. METHODS Six case-control studies from StoP project collected data on leisure-time PA, for a total of 2,343 cases and 8,614 controls. Subjects were classified into three leisure-time PA categories, either none/low, intermediate or high, based on study-specific tertiles. We used a two-stage approach. Firstly, we applied multivariable logistic regression models to obtain study-specific odds ratios (ORs) and corresponding 95% confidence intervals (CIs) then, we used a random-effect models to obtain pooled effect estimates. We performed stratified analyses according to demographic, lifestyle and clinical covariates. RESULTS The meta-analysis showed ORs of GC with no significant differences between intermediate vs low and high vs low PA level (OR 1.05 [95%CI 0.76-1.45]; OR 1.23 [95%CI 0.78-1.94], respectively). GC risk estimates did not strongly differ across strata of selected covariates except for age ≤ 55 years old (high vs low level: OR 0.72 [95%CI 0.55-0.94]) and for control population-based studies (high vs low level: OR 0.79 [95%CI 0.68-0.93]). CONCLUSIONS No association was found between leisure time PA and GC, apart from a slight suggestion of decreased risk below age 55 and in control population-based studies. These results may reflect specific characteristics of GC at a younger age, or the presence of a cohort effect mediating and interacting with socioeconomic determinants of GC The different distribution of PA levels among hospitalized controls could have led to an underestimated effect of PA on GC risk.
Collapse
Affiliation(s)
- Marco Mariani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Roberta Pastorino
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Denise Pires Marafon
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ken C. Johnson
- School of Epidemiology and Public Health, Department of Medicine University of Ottawa, Ottawa, Ontario, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Antonio Jose Molina de la Torre
- Biomedicine Institute (IBIOMED), University of León, León, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Guillermo Fernández-Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Health Research Institute of Asturias, ISPA and IUOPA, University of Oviedo, Oviedo, Spain
| | - David Zaridze
- Department of Clinical Epidemiology, N.N.Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Dmitry Maximovich
- Department of Clinical Epidemiology, N.N.Blokhin National Medical Research Center for Oncology, Moscow, Russia
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, United States of America
| | - Robert C. Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, United States of America
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| |
Collapse
|
8
|
Collatuzzo G, Negri E, Pelucchi C, Bonzi R, Turati F, Rabkin CS, Liao LM, Sinha R, Palli D, Ferraroni M, López-Carrillo L, Lunet N, Morais S, Albanes D, Weinstein SJ, Parisi D, Zaridze D, Maximovitch D, Dierssen-Sotos T, Jiménez-Moleón JJ, Vioque J, Garcia de la Hera M, Curado MP, Dias-Neto E, Hernández-Ramírez RU, López-Cervantes M, Ward MH, Tsugane S, Hidaka A, Lagiou A, Lagiou P, Zhang ZF, Trichopoulou A, Karakatsani A, Camargo MC, La Vecchia C, Boffetta P. Yoghurt Intake and Gastric Cancer: A Pooled Analysis of 16 Studies of the StoP Consortium. Nutrients 2023; 15:nu15081877. [PMID: 37111097 PMCID: PMC10147010 DOI: 10.3390/nu15081877] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/13/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Yoghurt can modify gastrointestinal disease risk, possibly acting on gut microbiota. Our study aimed at exploring the under-investigated association between yoghurt and gastric cancer (GC). METHODS We pooled data from 16 studies from the Stomach Cancer Pooling (StoP) Project. Total yoghurt intake was derived from food frequency questionnaires. We calculated study-specific odds ratios (ORs) of GC and the corresponding 95% confidence intervals (CIs) for increasing categories of yoghurt consumption using univariate and multivariable unconditional logistic regression models. A two-stage analysis, with a meta-analysis of the pooled adjusted data, was conducted. RESULTS The analysis included 6278 GC cases and 14,181 controls, including 1179 cardia and 3463 non-cardia, 1191 diffuse and 1717 intestinal cases. The overall meta-analysis revealed no association between increasing portions of yoghurt intake (continuous) and GC (OR = 0.98, 95% CI = 0.94-1.02). When restricting to cohort studies, a borderline inverse relationship was found (OR = 0.93, 95% CI = 0.88-0.99). The adjusted and unadjusted OR were 0.92 (95% CI = 0.85-0.99) and 0.78 (95% CI = 0.73-0.84) for any vs. no yoghurt consumption and GC risk. The OR for 1 category of increase in yoghurt intake was 0.96 (95% CI = 0.91-1.02) for cardia, 1.03 (95% CI = 1.00-1.07) for non-cardia, 1.12 (95% CI = 1.07-1.19) for diffuse and 1.02 (95% CI = 0.97-1.06) for intestinal GC. No effect was seen within hospital-based and population-based studies, nor in men or women. CONCLUSIONS We found no association between yoghurt and GC in the main adjusted models, despite sensitivity analyses suggesting a protective effect. Additional studies should further address this association.
Collapse
Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Federica Turati
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, 50139 Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | | | - Nuno Lunet
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, 4200-450 Porto, Portugal
| | - Samantha Morais
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, 4200-450 Porto, Portugal
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | - Dominick Parisi
- Information management Services, Inc., Silver Spring, MD 20904, USA
| | - David Zaridze
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, 115478 Moscow, Russia
| | - Dmitry Maximovitch
- Department of Clinical Epidemiology, N.N. Blokhin National Medical Research Center for Oncology, 115478 Moscow, Russia
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Cantabria-IDIVAL, 39005 Santander, Spain
| | - José Juan Jiménez-Moleón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18010 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), 03202 Alicante, Spain
| | - Manoli Garcia de la Hera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), 03202 Alicante, Spain
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo 01508-010, Brazil
| | - Emmanuel Dias-Neto
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo 01508-010, Brazil
| | | | | | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo 104-0045, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo 104-0045, Japan
| | - Areti Lagiou
- Department of Public and Community Health, School of Public Health, University of West Attica, 11521 Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Jonsson Comprehensive Cancer Center, Los Angeles, CA 10833, USA
| | | | - Anna Karakatsani
- Hellenic Health Foundation, 11527 Athens, Greece
- 2nd Pulmonary Medicine Department, Medical School, "ATTIKON" University Hospital, National and Kapodistrian University of Athens, 11527 Haidari, Greece
| | - Maria Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
| |
Collapse
|
9
|
Muscogiuri G, Barrea L, Cantone MC, Guarnotta V, Mazzilli R, Verde L, Vetrani C, Colao A, Faggiano A. Neuroendocrine Tumors: A Comprehensive Review on Nutritional Approaches. Cancers (Basel) 2022; 14:cancers14184402. [PMID: 36139562 PMCID: PMC9496842 DOI: 10.3390/cancers14184402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Neuroendocrine neoplasms are a heterogeneous group of neoplasms with increasing incidence, high prevalence, and survival worldwide. About 90% of cases are well differentiated forms, the so-called neuroendocrine tumors (NETs), with slow proliferation rates and prolonged survival but frequent development of liver metastases and endocrine syndromes. Both the tumor itself and systemic therapy may have an impact on patient nutrition. Malnutrition has a negative impact on outcome in patients with NETs, as well as obesity. In addition, obesity and metabolic syndrome have been shown to be risk factors for both the development and prognosis of NET. Therefore, dietary assessment based on body composition and lifestyle modifications should be an integral part of the treatment of NET patients. Nutrition plans, properly formulated by a dietician, are an integral part of the multidisciplinary treatment team for patients with NETs because they allow an improvement in quality of life, providing a tailored approach based on nutritional needs and nutritional manageable signs and/or symptoms related to pharmacological treatment. The aim of this review is to condense the latest evidence on the role of the most used dietary models, the Mediterranean diet, the ketogenic diet, and intermittent fasting, in the context of NETs, while considering the clinical and molecular mechanisms by which these dietary models act.
Collapse
Affiliation(s)
- Giovanna Muscogiuri
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia ed Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, 80131 Naples, Italy
- Cattedra Unesco “Educazione alla Salute e allo Sviluppo Sostenibile”, Università Federico II, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-0817463779; Fax: +39-081-746-3688
| | - Luigi Barrea
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, 80131 Naples, Italy
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro Direzionale, Isola F2, 80143 Naples, Italy
| | - Maria Celeste Cantone
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, 20157 Milan, Italy
| | - Valentina Guarnotta
- Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, 90127 Palermo, Italy
| | - Rossella Mazzilli
- Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, 80131 Naples, Italy
| | - Claudia Vetrani
- Unità di Endocrinologia, Diabetologia ed Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, 80131 Naples, Italy
- Cattedra Unesco “Educazione alla Salute e allo Sviluppo Sostenibile”, Università Federico II, 80131 Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, 80131 Naples, Italy
- Unità di Endocrinologia, Diabetologia ed Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, 80131 Naples, Italy
- Cattedra Unesco “Educazione alla Salute e allo Sviluppo Sostenibile”, Università Federico II, 80131 Naples, Italy
| | - Antongiulio Faggiano
- Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy
| |
Collapse
|
10
|
Tea consumption and gastric cancer: a pooled analysis from the Stomach cancer Pooling (StoP) Project consortium. Br J Cancer 2022; 127:726-734. [PMID: 35610368 PMCID: PMC9381730 DOI: 10.1038/s41416-022-01856-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 04/19/2022] [Accepted: 05/10/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Evidence from epidemiological studies on the role of tea drinking in gastric cancer risk remains inconsistent. We aimed to investigate and quantify the relationship between tea consumption and gastric cancer in the Stomach cancer Pooling (StoP) Project consortium. METHODS A total of 9438 cases and 20,451 controls from 22 studies worldwide were included. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of gastric cancer for regular versus non-regular tea drinkers were estimated by one and two-stage modelling analyses, including terms for sex, age and the main recognised risk factors for gastric cancer. RESULTS Compared to non-regular drinkers, the estimated adjusted pooled OR for regular tea drinkers was 0.91 (95% CI: 0.85-0.97). When the amount of tea consumed was considered, the OR for consumption of 1-2 cups/day was 1.01 (95% CI: 0.94-1.09) and for >3 cups/day was 0.91 (95% CI: 0.80-1.03). Stronger inverse associations emerged among regular drinkers in China and Japan (OR: 0.67, 95% CI: 0.49-0.91) where green tea is consumed, in subjects with H. pylori infection (OR: 0.68, 95% CI: 0.58-0.80), and for gastric cardia cancer (OR: 0.64, 95% CI: 0.49-0.84). CONCLUSION Our results indicate a weak inverse association between tea consumption and gastric cancer.
Collapse
|
11
|
Collatuzzo G, Alicandro G, Bertuccio P, Pelucchi C, Bonzi R, Palli D, Ferraroni M, Ye W, Plymoth A, Zaridze D, Maximovich D, Aragones N, Castaño-Vinyals G, Vioque J, Garcia de la Hera M, Zhang ZF, Hu J, Lopez-Carrillo L, López-Cervantes M, Dalmartello M, Mu L, Ward MH, Rabkin C, Yu GP, Camargo MC, Curado MP, Lunet N, Negri E, La Vecchia C, Boffetta P. Peptic ulcer as mediator of the association between risk of gastric cancer and socioeconomic status, tobacco smoking, alcohol drinking and salt intake. J Epidemiol Community Health 2022; 76:jech-2022-219074. [PMID: 35831132 DOI: 10.1136/jech-2022-219074] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/25/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Peptic ulcer disease (PUD) and gastric cancer (GC) are more prevalent in individuals with low socioeconomic status (SES) and share several risk factors. The aim of this study was to investigate the mediating role of PUD in the association between established risk factors and GC. METHODS We conducted a pooled analysis of 12 studies from the Stomach Cancer Pooling Project Consortium, including a total of 4877 GC cases and 11 808 controls. We explored the mediating role of PUD in the association between SES, tobacco smoking, heavy alcohol drinking and salt intake, and GC. Also, we assessed the ORs and 95% CIs of the risk factors and both PUD and GC. RESULTS PUD mediated 36% of the smoking effect mainly among men. Other risk factors were only slightly mediated by PUD (SES, 5.3%; heavy alcohol drinking, 3.3%; and salt intake, 2.5%). No significant difference was found when excluding PUD diagnosed within 2 years from GC. CONCLUSIONS Our study provides innovative information on the mechanism of stomach mucosal damage leading to PUD and GC, with respect to the effect of tobacco smoking in particular.
Collapse
Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
- Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amelie Plymoth
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovich
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Nuria Aragones
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Barcelona Institute for Global Health-ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain
| | - Manoli Garcia de la Hera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Jinfu Hu
- Harbin Medical University, Harbin, People's Republic of China
| | | | | | - Michela Dalmartello
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Charles Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, People's Republic of China
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
| |
Collapse
|
12
|
Inverse Association between Dietary Iron Intake and Gastric Cancer: A Pooled Analysis of Case-Control Studies of the Stop Consortium. Nutrients 2022; 14:nu14122555. [PMID: 35745285 PMCID: PMC9228527 DOI: 10.3390/nu14122555] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Inconsistent findings have been reported regarding the relationship between dietary iron intake and the risk of gastric cancer (GC). Methods: We pooled data from 11 case-control studies from the Stomach Cancer Pooling (StoP) Project. Total dietary iron intake was derived from food frequency questionnaires combined with national nutritional tables. We derived the odds ratios (ORs) and 95% confidence intervals (CIs) for quartiles of dietary iron through multivariable unconditional logistic regression models. Secondary analyses stratified by sex, smoking status, caloric intake, anatomical subsite and histological type were performed. Results: Among 4658 cases and 12247 controls, dietary iron intake was inversely associated with GC (per quartile OR 0.88; 95% CI: 0.83-0.93). Results were similar between cardia (OR = 0.85, 95% CI = 0.77-0.94) and non-cardia GC (OR = 0.87, 95% CI = 0.81-0.94), and for diffuse (OR = 0.79, 95% CI = 0.69-0.89) and intestinal type (OR = 0.88, 95% CI = 0.79-0.98). Iron intake exerted an independent effect from that of smoking and salt intake. Additional adjustment by meat and fruit/vegetable intake did not alter the results. Conclusions: Dietary iron is inversely related to GC, with no difference by subsite or histological type. While the results should be interpreted with caution, they provide evidence against a direct effect of iron in gastric carcinogenesis.
Collapse
|
13
|
Dalmartello M, Turati F, Zhang ZF, Lunet N, Rota M, Bonzi R, Galeone C, Martimianaki G, Palli D, Ferraroni M, Yu GP, Morais S, Malekzadeh R, López-Carrillo L, Zaridze D, Maximovitch D, Aragonés N, Fernández-Tardón G, Martin V, Vioque J, Garcia de la Hera M, Curado MP, Coimbra FJF, Assumpcao P, Pakseresht M, Hu J, Hernández-Ramírez RU, Ward MH, Pourfarzi F, Mu L, Tsugane S, Hidaka A, Lagiou P, Lagiou A, Trichopoulou A, Karakatsani A, Boffetta P, Camargo MC, Negri E, La Vecchia C, Pelucchi C. Allium vegetables intake and the risk of gastric cancer in the Stomach cancer Pooling (StoP) Project. Br J Cancer 2022; 126:1755-1764. [PMID: 35210588 PMCID: PMC9174191 DOI: 10.1038/s41416-022-01750-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/21/2022] [Accepted: 02/09/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The role of allium vegetables on gastric cancer (GC) risk remains unclear. METHODS We evaluated whether higher intakes of allium vegetables reduce GC risk using individual participant data from 17 studies participating in the "Stomach cancer Pooling (StoP) Project", including 6097 GC cases and 13,017 controls. Study-specific odds ratios (ORs) were pooled using a two-stage modelling approach. RESULTS Total allium vegetables intake was inversely associated with GC risk. The pooled OR for the highest versus the lowest study-specific tertile of consumption was 0.71 (95% confidence interval, CI, 0.56-0.90), with substantial heterogeneity across studies (I2 > 50%). Pooled ORs for high versus low consumption were 0.69 (95% CI, 0.55-0.86) for onions and 0.83 (95% CI, 0.75-0.93) for garlic. The inverse association with allium vegetables was evident in Asian (OR 0.50, 95% CI, 0.29-0.86) but not European (OR 0.96, 95% CI, 0.81-1.13) and American (OR 0.66, 95% CI, 0.39-1.11) studies. Results were consistent across all other strata. CONCLUSIONS In a worldwide consortium of epidemiological studies, we found an inverse association between allium vegetables and GC, with a stronger association seen in Asian studies. The heterogeneity of results across geographic regions and possible residual confounding suggest caution in results interpretation.
Collapse
Affiliation(s)
- Michela Dalmartello
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Federica Turati
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. .,Unit of Medical Statistics and Biometry, National Cancer Institute of Milan, Milan, Italy.
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Rossella Bonzi
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Carlotta Galeone
- Bicocca Applied Statistics Center (B-ASC), Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Georgia Martimianaki
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Hellenic Health Foundation, Athens, Greece
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Cancer Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | | | - Vicente Martin
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, 46020, Alicante, Spain
| | - Manoli Garcia de la Hera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, 46020, Alicante, Spain
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | | | - Paulo Assumpcao
- Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém, 66073-000, Brazil
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada.,Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | | | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.,National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece.,2nd Pulmonary Medicine Department, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Haidari, Greece
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - M Costanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Eva Negri
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Claudio Pelucchi
- Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| |
Collapse
|
14
|
Dabo B, Pelucchi C, Rota M, Jain H, Bertuccio P, Bonzi R, Palli D, Ferraroni M, Zhang ZF, Sanchez-Anguiano A, Thi-Hai Pham Y, Thi-Du Tran C, Gia Pham A, Yu GP, Nguyen TC, Muscat J, Tsugane S, Hidaka A, Hamada GS, Zaridze D, Maximovitch D, Kogevinas M, Fernàndez de Larrea N, Boccia S, Pastorino R, Kurtz RC, Lagiou A, Lagiou P, Vioque J, Camargo MC, Paula Curado M, Lunet N, Boffetta P, Negri E, La Vecchia C, Luu HN. The association between diabetes and gastric cancer: results from the Stomach Cancer Pooling Project Consortium. Eur J Cancer Prev 2022; 31:260-269. [PMID: 34183534 PMCID: PMC8709871 DOI: 10.1097/cej.0000000000000703] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 04/23/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Prior epidemiologic studies on the association between diabetes and gastric cancer risk provided inconclusive findings, while traditional, aggregate data meta-analyses were characterized by high between-study heterogeneity. OBJECTIVE To investigate the association between type 2 diabetes and gastric cancer using data from the 'Stomach Cancer Pooling (StoP) Project', an international consortium of more than 30 case-control and nested case-control studies, which is large and provides harmonized definition of participants' characteristics across individual studies. The data have the potential to minimize between-study heterogeneity and provide greater statistical power for subgroup analysis. METHODS We included 5592 gastric cancer cases and 12 477 controls from 14 studies from Europe, Asia, North America, and South America in a two-stage individual-participant data meta-analysis. Random-effect models were used to estimate summary odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) by pooling study-specific ORs. RESULTS We did not find an overall association between diabetes and gastric cancer (pooled OR = 1.01, 95% CI, 0.94-1.07). However, the risk of cardia gastric cancer was significantly higher among individuals with type 2 diabetes (OR = 1.16, 95% CI, 1.02-1.33). There was no association between diabetes and gastric cancer risk in strata of Helicobacter pylori infection serostatus, age, sex, BMI, smoking status, alcohol consumption, fruit/vegetable intake, gastric cancer histologic type, and source of controls. CONCLUSION This study provides additional evidence that diabetes is unrelated to gastric cancer overall but may be associated with excess cardia gastric cancer risk.
Collapse
Affiliation(s)
- Bashir Dabo
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Harshonnati Jain
- Department of Information Systems and Decision Sciences (ISDS), Muma College of Business, University of South Florida, Tampa, Florida, USA
| | - Paola Bertuccio
- Department of Biomedical and Clinical Sciences, University of Milan, Milan
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | | | - Yen Thi-Hai Pham
- Department of Rehabilitation, Vinmec Hospital Times City, Vinmec Healthcare System
| | - Chi Thi-Du Tran
- Vietnam Colorectal Cancer and Polyps Research Program, Vinmec Healthcare System
| | - Anh Gia Pham
- Department of Surgical Oncology, Viet-Duc University Hospital, Hanoi, Vietnam
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Tin C. Nguyen
- Department of Computer Sciences and Engineering, University of Nevada-Reno, Reno, Nevada
| | - Joshua Muscat
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan
| | | | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid
- ISGlobal
- IMIM (Hospital del Mar Medical Research Institute)
- Universitat Pompeu Fabra (UPF), Barcelona
| | - Nerea Fernàndez de Larrea
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid
- Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore
- Department of Woman and Child Health and Public Health – Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Roberta Pastorino
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore
| | - Robert C. Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jesus Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Campus San Juan, Alicante, Spain
| | - M. Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, New York, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan
| | - Hung N. Luu
- UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
15
|
Sultana S, Bouyahya A, Rebezov M, Shariati MA, Balahbib A, Khouchlaa A, El Yaagoubi OM, Khaliq A, Omari NE, Bakrim S, Zengin G, Akram M, Khayrullin M, Bogonosova I, Mahmud S, Simal-Gandara J. Impacts of nutritive and bioactive compounds on cancer development and therapy. Crit Rev Food Sci Nutr 2022; 63:9187-9216. [PMID: 35416738 DOI: 10.1080/10408398.2022.2062699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
For persons who survive with progressive cancer, nutritional therapy and exercise may be significant factors to improve the health condition and life quality of cancer patients. Nutritional therapy and medications are essential to managing progressive cancer. Cancer survivors, as well as cancer patients, are mostly extremely encouraged to search for knowledge about the selection of diet, exercise, and dietary supplements to recover as well as maintain their treatment consequences, living quality, and survival of patients. A healthy diet plays an important role in cancer treatment. Different articles are studied to collect information and knowledge about the use of nutrients in cancer treatment as well as cancer prevention. The report deliberates nutrition and exercise strategies during the range of cancer care, emphasizing significant concerns during treatment of cancer and for patients of advanced cancer, but concentrating mostly on the requirements of the population of persons who are healthy or who have constant disease following their repossession from management. It also deliberates choice nutrition and exercise problems such as dietary supplements, food care, food selections, and weight; problems interrelated to designated cancer sites, and common questions about diet, and cancer survival. Decrease the side effects of medicines both during and after treatment.
Collapse
Affiliation(s)
- Sabira Sultana
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathology Biology, Faculty of Sciences, and Genomic Center of Human Pathology, Mohammed V University, Rabat, Morocco
| | - Maksim Rebezov
- V M Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Moscow, Russian Federation
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Mohammad Ali Shariati
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Abdelaali Balahbib
- Laboratory of Biodiversity, Ecology, and Genome, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Aya Khouchlaa
- Laboratory of Human Pathology Biology, Faculty of Sciences, and Genomic Center of Human Pathology, Mohammed V University, Rabat, Morocco
| | - Ouadie Mohamed El Yaagoubi
- Laboratory of Biochemistry, Environment and Agri-Food (URAC 36) - Faculty of Sciences and Techniques - Mohammedia, Hassan II University Casablanca - Morocco
| | - Adnan Khaliq
- Department of Food Science and Technology, Khwaja Fareed University of Engineering and Information Technology, Pakistan
| | - Nasreddine El Omari
- Laboratory of Histology, Embryology, and Cytogenetic, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Saad Bakrim
- Molecular Engineering, Valorization and Environment Team, Polydisciplinary Faculty of Taroudant, Ibn Zohr University, Agadir, Morocco
| | - Gokhan Zengin
- Department of Biology, Science Faculty, Selcuk University, Konya, Turkey
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Pakistan
| | - Mars Khayrullin
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Irina Bogonosova
- K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), Moscow, Russian Federation
| | - Shafi Mahmud
- Genetic Engineering and Biotechnology, University of Rajshahi, Rajshahi, Bangladesh
| | - Jesus Simal-Gandara
- Department of Analytical Chemistry and Food Science, Faculty of Science, Universidade de Vigo, Nutrition and Bromatology Group, Ourense, Spain
| |
Collapse
|
16
|
Salt intake and gastric cancer: a pooled analysis within the Stomach cancer Pooling (StoP) Project. Cancer Causes Control 2022; 33:779-791. [PMID: 35304655 DOI: 10.1007/s10552-022-01565-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/22/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE Previous studies show that consuming foods preserved by salting increases the risk of gastric cancer, while results on the association between total salt or added salt and gastric cancer are less consistent and vary with the exposure considered. This study aimed to quantify the association between dietary salt exposure and gastric cancer, using an individual participant data meta-analysis of studies participating in the Stomach cancer Pooling (StoP) Project. METHODS Data from 25 studies (10,283 cases and 24,643 controls) from the StoP Project with information on salt taste preference (tasteless, normal, salty), use of table salt (never, sometimes, always), total sodium intake (tertiles of grams/day), and high-salt and salt-preserved foods intake (tertiles of grams/day) were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age, and gastric cancer risk factors) odds ratios (aORs), and the corresponding 95% confidence intervals (95% CI). RESULTS Gastric cancer risk was higher for salty taste preference (aOR 1.59, 95% CI 1.25-2.03), always using table salt (aOR 1.33, 95% CI 1.16-1.54), and for the highest tertile of high-salt and salt-preserved foods intake (aOR 1.24, 95% CI 1.01-1.51) vs. the lowest tertile. No significant association was observed for the highest vs. the lowest tertile of total sodium intake (aOR 1.08, 95% CI 0.82-1.43). The results obtained were consistent across anatomic sites, strata of Helicobacter pylori infection, and sociodemographic, lifestyle and study characteristics. CONCLUSION Salty taste preference, always using table salt, and a greater high-salt and salt-preserved foods intake increased the risk of gastric cancer, though the association was less robust with total sodium intake.
Collapse
|
17
|
Martimianaki G, Bertuccio P, Alicandro G, Pelucchi C, Bravi F, Carioli G, Bonzi R, Rabkin CS, Liao LM, Sinha R, Johnson K, Hu J, Palli D, Ferraroni M, Lunet N, Morais S, Tsugane S, Hidaka A, Hamada GS, López-Carrillo L, Hernández-Ramírez RU, Zaridze D, Maximovitch D, Aragonés N, Martin V, Ward MH, Vioque J, de la Hera MG, Zhang ZF, Kurtz RC, Lagiou P, Lagiou A, Trichopoulou A, Karakatsani A, Malekzadeh R, Camargo MC, Curado MP, Boccia S, Boffetta P, Negri E, Vecchia CL. Coffee consumption and gastric cancer: a pooled analysis from the Stomach cancer Pooling Project consortium. Eur J Cancer Prev 2022; 31:117-127. [PMID: 34545022 PMCID: PMC8972971 DOI: 10.1097/cej.0000000000000680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate and quantify the relationship between coffee and gastric cancer using a uniquely large dataset from an international consortium of observational studies on gastric cancer, including data from 18 studies, for a total of 8198 cases and 21 419 controls. METHODS A two-stage approach was used to obtain the pooled odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) for coffee drinkers versus never or rare drinkers. A one-stage logistic mixed-effects model with a random intercept for each study was used to estimate the dose-response relationship. Estimates were adjusted for sex, age and the main recognized risk factors for gastric cancer. RESULTS Compared to never or rare coffee drinkers, the estimated pooled OR for coffee drinkers was 1.03 (95% CI, 0.94-1.13). When the amount of coffee intake was considered, the pooled ORs were 0.91 (95% CI, 0.81-1.03) for drinkers of 1-2 cups per day, 0.95 (95% CI, 0.82-1.10) for 3-4 cups, and 0.95 (95% CI, 0.79-1.15) for five or more cups. An OR of 1.20 (95% CI, 0.91-1.58) was found for heavy coffee drinkers (seven or more cups of caffeinated coffee per day). A positive association emerged for high coffee intake (five or more cups per day) for gastric cardia cancer only. CONCLUSIONS These findings better quantify the previously available evidence of the absence of a relevant association between coffee consumption and gastric cancer.
Collapse
Affiliation(s)
- Georgia Martimianaki
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Hellenic Health Foundation, Athens, Greece
| | - Paola Bertuccio
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Francesca Bravi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Greta Carioli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Charles S. Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Linda M. Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Ken Johnson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Nuno Lunet
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | | | | | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Epidemiology Section, Public Health Division, Department of Health of Madrid, Spain
| | - Vicente Martin
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Research Group in Gene-Environment Interactions and Health, University of León, León, Spain
| | - Mary H. Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, Alicante, Spain
| | - Manoli Garcia de la Hera
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH, Alicante, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Robert C. Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece
| | | | - Anna Karakatsani
- Hellenic Health Foundation, Athens, Greece
- 2nd Pulmonary Medicine Department, National and Kapodistrian University of Athens, Medical School, “ATTIKON” University Hospital, Haidari, Greece
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| |
Collapse
|
18
|
Czarnecka K, Pilarz A, Rogut A, Maj P, Szymańska J, Olejnik Ł, Szymański P. Aspartame-True or False? Narrative Review of Safety Analysis of General Use in Products. Nutrients 2021; 13:1957. [PMID: 34200310 PMCID: PMC8227014 DOI: 10.3390/nu13061957] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/14/2022] Open
Abstract
Aspartame is a sweetener introduced to replace the commonly used sucrose. It was discovered by James M. Schlatter in 1965. Being 180-200 times sweeter than sucrose, its intake was expected to reduce obesity rates in developing countries and help those struggling with diabetes. It is mainly used as a sweetener for soft drinks, confectionery, and medicines. Despite its widespread use, its safety remains controversial. This narrative review investigates the existing literature on the use of aspartame and its possible effects on the human body to refine current knowledge. Taking to account that aspartame is a widely used artificial sweetener, it seems appropriate to continue research on safety. Studies mentioned in this article have produced very interesting results overall, the current review highlights the social problem of providing visible and detailed information about the presence of aspartame in products. The studies involving the impact of aspartame on obesity, diabetes mellitus, children and fetus, autism, neurodegeneration, phenylketonuria, allergies and skin problems, its cancer properties and its genotoxicity were analyzed. Further research should be conducted to ensure clear information about the impact of aspartame on health.
Collapse
Affiliation(s)
- Kamila Czarnecka
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, 4 Kozielska St., 01-163 Warsaw, Poland
| | - Aleksandra Pilarz
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Aleksandra Rogut
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Patryk Maj
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Joanna Szymańska
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Łukasz Olejnik
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Paweł Szymański
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, 4 Kozielska St., 01-163 Warsaw, Poland
| |
Collapse
|
19
|
Darooghegi Mofrad M, Mozaffari H, Askari MR, Amini MR, Jafari A, Surkan PJ, Azadbakht L. Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies. Adv Nutr 2021; 12:1705-1722. [PMID: 33861304 PMCID: PMC8483953 DOI: 10.1093/advances/nmab024] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 05/29/2020] [Accepted: 02/04/2021] [Indexed: 12/29/2022] Open
Abstract
The etiology of cancer type may vary significantly due to anatomy, embryology, and physiology of the cancer site. Although the association between potato consumption and colorectal cancer (CRC) was summarized in a 2018 meta-analysis of 5 cohort studies, to the best of our knowledge, no meta-analysis has evaluated potato consumption in relation to multiple cancer sites in adults. Medline/PubMed, ISI Web of Knowledge, Scopus, and the Cochrane Database of Systematic Reviews were searched for relevant publications through August 2020. We selected cohort or case-control studies conducted in adults that reported risk estimates (relative risk [RRs], HRs, and ORs) of potato intake for any cancer type. Random effects meta-analyses compared high and low intake categories. Twenty prospective cohort studies (total n = 785,348) including 19,882 incident cases, and 36 case-control studies (21,822 cases; 66,502 controls) were included. Among cohort studies, we did not find an association between high versus low intake of total potato (white and yellow) consumption and overall cancers: 1.04 (95% CI: 0.96, 1.11; tau2 = 0.005, n = 18). We found no relation between total potato consumption (high compared with low intake) and risk of CRC, pancreatic cancer, colon, gastric, breast, prostate, kidney, lung, or bladder cancer in cohort or case-control studies. We did not find an association between high versus low consumption of potato preparations (boiled/fried/mashed/roasted/baked) and risk of gastrointestinal-, sex-hormone-, or urinary-related cancers in cohort or case-control studies. Certainty of the evidence was low for total cancer, CRC, colon, rectal, renal, pancreatic, breast, prostate, and lung cancer and very low for gastric and bladder cancer. In conclusion, potato intake or potato preparations were not associated with multiple cancer sites when comparing high and low intake categories. This finding was consistent with the findings from the 2018 meta-analysis regarding potato intake and risk of CRC.
Collapse
Affiliation(s)
- Manije Darooghegi Mofrad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadis Mozaffari
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Mohammad Reza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Amini
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Jafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | |
Collapse
|
20
|
Deng W, Jin L, Zhuo H, Vasiliou V, Zhang Y. Alcohol consumption and risk of stomach cancer: A meta-analysis. Chem Biol Interact 2021; 336:109365. [PMID: 33412155 DOI: 10.1016/j.cbi.2021.109365] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 11/27/2020] [Accepted: 12/30/2020] [Indexed: 12/16/2022]
Abstract
Stomach cancer is one of the most common cancers in the world. The relationship between alcohol consumption and the risk of stomach cancer remains unclear. Epidemiology studies investigating this relationship have shown inconsistent findings. A meta-analysis was performed to explore the association between alcohol consumption and increased stomach cancer risk. Eighty-one epidemiology studies, including 68 case-control studies and 13 cohort studies, were included in this study. A significant association was found between alcohol consumption and increased risk of stomach cancer (OR = 1.20, 95% CI 1.12-1.27). To explore the source of the significant heterogeneity (p < 0.05, I2 = 86%), analysis was stratified by study type (case-control study and cohort study), control type (hospital-based control and population-based control), gender (male, female, and mix), race (White and Asian), region (United States, Sweden, China, Japan), subsite of stomach cancer, and type of alcohol. The stratified analyses found that region and cancer subsite are major sources of the high heterogeneity. The inconsistent results in different regions and different subsites might be related to smoking rates, Helicobacter pylori infection, obesity, and potential genetic susceptibility. The positive association between drinking and increased risk of stomach cancer is consistent in stratified analyses. The dose-response analysis showed a clear trend that a higher daily intake of alcohol is associated with a higher risk of stomach cancer.
Collapse
Affiliation(s)
- Wenting Deng
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Lan Jin
- Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Haoran Zhuo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Vasilis Vasiliou
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Cancer Center, New Haven, CT, USA
| | - Yawei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
21
|
Ferro A, Costa AR, Morais S, Bertuccio P, Rota M, Pelucchi C, Hu J, Johnson KC, Zhang ZF, Palli D, Ferraroni M, Yu GP, Bonzi R, Peleteiro B, López-Carrillo L, Tsugane S, Hamada GS, Hidaka A, Malekzadeh R, Zaridze D, Maximovitch D, Vioque J, Navarrete-Munoz EM, Alguacil J, Castaño-Vinyals G, Wolk A, Håkansson N, Hernández-Ramírez RU, Pakseresht M, Ward MH, Pourfarzi F, Mu L, López-Cervantes M, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, Camargo MC, Curado MP, La Vecchia C, Lunet N. Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project. Int J Cancer 2020; 147:3090-3101. [PMID: 32525569 PMCID: PMC8545605 DOI: 10.1002/ijc.33134] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 03/20/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022]
Abstract
A low intake of fruits and vegetables is a risk factor for gastric cancer, although there is uncertainty regarding the magnitude of the associations. In our study, the relationship between fruits and vegetables intake and gastric cancer was assessed, complementing a previous work on the association betweenconsumption of citrus fruits and gastric cancer. Data from 25 studies (8456 cases and 21 133 controls) with information on fruits and/or vegetables intake were used. A two-stage approach based on random-effects models was used to pool study-specific adjusted (sex, age and the main known risk factors for gastric cancer) odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Exposure-response relations, including linear and nonlinear associations, were modeled using one- and two-order fractional polynomials. Gastric cancer risk was lower for a higher intake of fruits (OR: 0.76, 95% CI: 0.64-0.90), noncitrus fruits (OR: 0.86, 95% CI: 0.73-1.02), vegetables (OR: 0.68, 95% CI: 0.56-0.84), and fruits and vegetables (OR: 0.61, 95% CI: 0.49-0.75); results were consistent across sociodemographic and lifestyles categories, as well as study characteristics. Exposure-response analyses showed an increasingly protective effect of portions/day of fruits (OR: 0.64, 95% CI: 0.57-0.73 for six portions), noncitrus fruits (OR: 0.71, 95% CI: 0.61-0.83 for six portions) and vegetables (OR: 0.51, 95% CI: 0.43-0.60 for 10 portions). A protective effect of all fruits, noncitrus fruits and vegetables was confirmed, supporting further dietary recommendations to decrease the burden of gastric cancer.
Collapse
Affiliation(s)
- Ana Ferro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana Rute Costa
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Kenneth C. Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson, Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Bárbara Peleteiro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Eva M. Navarrete-Munoz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona,Spain
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
| | - Mary H. Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | | | - Roberto Persiani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Roma, Italia
- Università Cattolica del Sacro Cuore, Dipartimento di Chirurgia, Roma, Italia
| | - Robert C. Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefania Boccia
- Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - M. Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brasil
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
| | - Nuno Lunet
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| |
Collapse
|
22
|
Polyphenol Intake and Gastric Cancer Risk: Findings from the Stomach Cancer Pooling Project (StoP). Cancers (Basel) 2020; 12:cancers12103064. [PMID: 33092262 PMCID: PMC7588964 DOI: 10.3390/cancers12103064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 12/21/2022] Open
Abstract
Simple Summary Gastric cancer (GC) has the fifth highest incidence of any cancer type worldwide and the third highest mortality rate, so its prevention is very important. Among dietary factors, the consumption of fruit and vegetables has been inversely related to GC risk. Phenolic compounds may exert a favorable effect on the risk of several cancer types, including gastric cancer. However, selected polyphenol classes have not been adequately investigated in relation to GC. There is, however, no comprehensive analysis of polyphenols and GC risk methods to date. In order to provide a detailed evaluation of the relationship between dietary intake of polyphenols and GC risk, we analyzed data from the Stomach cancer Pooling (StoP) Project consortium. Abstract Phenolic compounds may exert a favorable effect on the risk of several cancer types, including gastric cancer (GC). However, selected polyphenol classes have not been adequately investigated in relation to GC. The aim of this study is to evaluate the association between the intake of polyphenols in relation to GC risk. We used data from the Stomach cancer Pooling (StoP) Project, including 10 studies from six countries (3471 GC cases and 8344 controls). We carried out an individual participant data pooled analysis using a two-stage approach. The summary odds ratios (ORs) of GC for each compound, and the corresponding 95% confidence intervals (95% CI), were computed by pooling study specific ORs obtained through multivariate logistic regression, using random effect models. Inverse associations with GC emerged for total polyphenols (OR = 0.67, 95% CI = 0.54–0.81, for the highest versus lowest quartile of intake), total flavonoids (OR = 0.73, 95% CI = 0.55–0.90), anthocyanidins (OR = 0.74, 95% CI = 0.56–0.92), flavanols (OR = 0.77, 95% CI = 0.66–0.88), flavanones (OR = 0.57, 95%CI = 0.44–0.69), total phenolic acids (OR = 0.75, 95%CI = 0.55–0.94), and hydroxybenzoic acids (OR = 0.73, 95%CI = 0.57–0.89). Results were consistent across strata of age, sex, social class, and smoking habit. Suggestive inverse associations were also found for flavonols (OR = 0.76, 95%CI = 0.51–1.01) and hydroxycinnamic acids (OR = 0.82, 95%CI = 0.58–1.06). Further investigations from longitudinal data are needed to confirm this association.
Collapse
|
23
|
Edefonti V, La Vecchia C, Di Maso M, Crispo A, Polesel J, Libra M, Parpinel M, Serraino D, Ferraroni M, Bravi F. Association between Nutrient-Based Dietary Patterns and Bladder Cancer in Italy. Nutrients 2020; 12:nu12061584. [PMID: 32481645 PMCID: PMC7353000 DOI: 10.3390/nu12061584] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 12/11/2022] Open
Abstract
Limited knowledge is available on dietary patterns and bladder cancer risk. We analyzed data from an Italian case-control study carried out between 2003 and 2014, including 690 incident bladder cancer cases and 665 hospital-controls. We derived nutrient-based dietary patterns applying principal component factor analysis on 28 selected nutrients. We categorized factor scores according to quartiles, and estimated the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) through logistic regression models, adjusted for major confounding factors. We identified four dietary patterns named "Animal products", "Vitamins and fiber", "Starch-rich", and "Animal unsaturated fatty acids". We found an inverse association between the "Vitamins and fiber" pattern and bladder cancer (OR = 0.70, 95% CI: 0.48-0.99, IV versus I quartile category). Inverse relationships of borderline significance were also found for the "Animal products" and the "Animal unsaturated fatty acids" dietary patterns. No significant association was evident for the "Starch-rich" pattern. The current study allowed us to identify major dietary patterns in this Italian population. Our study confirms available evidence and shows that scoring high on a fruit-and-vegetables pattern provides beneficial effects on bladder cancer risk.
Collapse
Affiliation(s)
- Valeria Edefonti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via A. Vanzetti, 5, 20133 Milan, Italy; (V.E.); (C.L.V.); (M.D.M.); (M.F.)
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via A. Vanzetti, 5, 20133 Milan, Italy; (V.E.); (C.L.V.); (M.D.M.); (M.F.)
| | - Matteo Di Maso
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via A. Vanzetti, 5, 20133 Milan, Italy; (V.E.); (C.L.V.); (M.D.M.); (M.F.)
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS “Fondazione G. Pascale”, via M. Semmola, 80131 Naples, Italy;
| | - Jerry Polesel
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini, 2, 33080 Aviano, Italy; (J.P.); (D.S.)
| | - Massimo Libra
- Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, Università di Catania, Via Santa Sofia, 97, 95123 Catania, Italy;
| | - Maria Parpinel
- Department of Medicine, University of Udine, via Colugna, 50, 33100 Udine, Italy;
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini, 2, 33080 Aviano, Italy; (J.P.); (D.S.)
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via A. Vanzetti, 5, 20133 Milan, Italy; (V.E.); (C.L.V.); (M.D.M.); (M.F.)
| | - Francesca Bravi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via A. Vanzetti, 5, 20133 Milan, Italy; (V.E.); (C.L.V.); (M.D.M.); (M.F.)
- Correspondence: ; Tel.: +39-02-5032074; Fax: +39-02-50320866
| |
Collapse
|
24
|
Ferro A, Rosato V, Rota M, Costa AR, Morais S, Pelucchi C, Johnson KC, Hu J, Palli D, Ferraroni M, Zhang ZF, Bonzi R, Yu GP, Peleteiro B, López-Carrillo L, Tsugane S, Hamada GS, Hidaka A, Zaridze D, Maximovitch D, Vioque J, Navarrete-Munoz EM, Aragonés N, Martín V, Hernández-Ramírez RU, Bertuccio P, Ward MH, Malekzadeh R, Pourfarzi F, Mu L, López-Cervantes M, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, Camargo MC, Curado MP, La Vecchia C, Lunet N. Meat intake and risk of gastric cancer in the Stomach cancer Pooling (StoP) project. Int J Cancer 2019; 147:45-55. [PMID: 31584199 DOI: 10.1002/ijc.32707] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/17/2019] [Accepted: 07/23/2019] [Indexed: 12/12/2022]
Abstract
The consumption of processed meat has been associated with noncardia gastric cancer, but evidence regarding a possible role of red meat is more limited. Our study aims to quantify the association between meat consumption, namely white, red and processed meat, and the risk of gastric cancer, through individual participant data meta-analysis of studies participating in the "Stomach cancer Pooling (StoP) Project". Data from 22 studies, including 11,443 cases and 28,029 controls, were used. Study-specific odds ratios (ORs) were pooled through a two-stage approach based on random-effects models. An exposure-response relationship was modeled, using one and two-order fractional polynomials, to evaluate the possible nonlinear association between meat intake and gastric cancer. An increased risk of gastric cancer was observed for the consumption of all types of meat (highest vs. lowest tertile), which was statistically significant for red (OR: 1.24; 95% CI: 1.00-1.53), processed (OR: 1.23; 95% CI: 1.06-1.43) and total meat (OR: 1.30; 95% CI: 1.09-1.55). Exposure-response analyses showed an increasing risk of gastric cancer with increasing consumption of both processed and red meat, with the highest OR being observed for an intake of 150 g/day of red meat (OR: 1.85; 95% CI: 1.56-2.20). This work provides robust evidence on the relation between the consumption of different types of meat and gastric cancer. Adherence to dietary recommendations to reduce meat consumption may contribute to a reduction in the burden of gastric cancer.
Collapse
Affiliation(s)
- Ana Ferro
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Valentina Rosato
- Unit of Medical Statistics, Biometry and Bioinformatics, National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - Matteo Rota
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Ana Rute Costa
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Kenneth C Johnson
- School of Epidemiology and Public Health, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Zuo-Feng Zhang
- Department of Epidemiology, Comprehensive Cancer Center, UCLA Fielding School of Public Health and Jonsson, Los Angeles, CA
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Bárbara Peleteiro
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | | | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Jesus Vioque
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Eva M Navarrete-Munoz
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Vicente Martín
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Research Group in Gene-Environment Interactions and Health, University of León, León, Spain
| | - Raúl Ulisses Hernández-Ramírez
- Mexico National Institute of Public Health, Morelos, Mexico.,Department of Biostatistics, Yale School of Medicine, Yale School of Public Health, New Haven, CT
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - Mary H Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | | | - Roberto Persiani
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Rome, Italy.,Dipartimento di Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Paolo Boffetta
- Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| |
Collapse
|
25
|
Rota M, Alicandro G, Pelucchi C, Bonzi R, Bertuccio P, Hu J, Zhang ZF, Johnson KC, Palli D, Ferraroni M, Yu GP, Galeone C, López-Carrillo L, Muscat J, Lunet N, Ferro A, Ye W, Plymoth A, Malekzadeh R, Zaridze D, Maximovitch D, Kogevinas M, Fernández de Larrea N, Vioque J, Navarrete-Muñoz EM, Tsugane S, Hamada GS, Hidaka A, Pakseresht M, Wolk A, Håkansson N, Hernández-Ramírez RU, López-Cervantes M, Ward M, Pourfarzi F, Mu L, Kurtz RC, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, La Vecchia C. Education and gastric cancer risk-An individual participant data meta-analysis in the StoP project consortium. Int J Cancer 2019; 146:671-681. [PMID: 30919464 DOI: 10.1002/ijc.32298] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/30/2019] [Accepted: 02/14/2019] [Indexed: 01/11/2023]
Abstract
Low socioeconomic position (SEP) is a strong risk factor for incidence and premature mortality from several cancers. Our study aimed at quantifying the association between SEP and gastric cancer (GC) risk through an individual participant data meta-analysis within the "Stomach cancer Pooling (StoP) Project". Educational level and household income were used as proxies for the SEP. We estimated pooled odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) across levels of education and household income by pooling study-specific ORs through random-effects meta-analytic models. The relative index of inequality (RII) was also computed. A total of 9,773 GC cases and 24,373 controls from 25 studies from Europe, Asia and America were included. The pooled OR for the highest compared to the lowest level of education was 0.60 (95% CI, 0.44-0.84), while the pooled RII was 0.45 (95% CI, 0.29-0.69). A strong inverse association was observed both for noncardia (OR 0.39, 95% CI, 0.22-0.70) and cardia GC (OR 0.47, 95% CI, 0.22-0.99). The relation was stronger among H. pylori negative subjects (RII 0.14, 95% CI, 0.04-0.48) as compared to H. pylori positive ones (RII 0.29, 95% CI, 0.10-0.84), in the absence of a significant interaction (p = 0.28). The highest household income category showed a pooled OR of 0.65 (95% CI, 0.48-0.89), while the corresponding RII was 0.40 (95% CI, 0.22-0.72). Our collaborative pooled-analysis showed a strong inverse relationship between SEP indicators and GC risk. Our data call for public health interventions to reduce GC risk among the more vulnerable groups of the population.
Collapse
Affiliation(s)
- Matteo Rota
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gianfranco Alicandro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Italian National Institute of Statistics, Rome, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Jinfu Hu
- Harbin Medical University, Harbin, China
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Carlotta Galeone
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Joshua Muscat
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Penn Sylvania State University College of Medicine, Hershey, PA, USA
| | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Ana Ferro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amelie Plymoth
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,ISGlobal, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Nerea Fernández de Larrea
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Jesus Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Eva M Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada.,Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Raúl Ulises Hernández-Ramírez
- Mexico National Institute of Public Health, Morelos, Mexico.,Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA
| | | | - Mary Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Areti Lagiou
- Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Stefania Boccia
- Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia.,Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italia
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| |
Collapse
|
26
|
Tobacco smoking and gastric cancer: meta-analyses of published data versus pooled analyses of individual participant data (StoP Project). Eur J Cancer Prev 2019; 27:197-204. [PMID: 29595756 DOI: 10.1097/cej.0000000000000401] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Tobacco smoking is one of the main risk factors for gastric cancer, but the magnitude of the association estimated by conventional systematic reviews and meta-analyses might be inaccurate, due to heterogeneous reporting of data and publication bias. We aimed to quantify the combined impact of publication-related biases, and heterogeneity in data analysis or presentation, in the summary estimates obtained from conventional meta-analyses. We compared results from individual participant data pooled-analyses, including the studies in the Stomach Cancer Pooling (StoP) Project, with conventional meta-analyses carried out using only data available in previously published reports from the same studies. From the 23 studies in the StoP Project, 20 had published reports with information on smoking and gastric cancer, but only six had specific data for gastric cardia cancer and seven had data on the daily number of cigarettes smoked. Compared to the results obtained with the StoP database, conventional meta-analyses overvalued the relation between ever smoking (summary odds ratios ranging from 7% higher for all studies to 22% higher for the risk of gastric cardia cancer) and yielded less precise summary estimates (SE ≤2.4 times higher). Additionally, funnel plot asymmetry and corresponding hypotheses tests were suggestive of publication bias. Conventional meta-analyses and individual participant data pooled-analyses reached similar conclusions on the direction of the association between smoking and gastric cancer. However, published data tended to overestimate the magnitude of the effects, possibly due to publication biases and limited the analyses by different levels of exposure or cancer subtypes.
Collapse
|
27
|
Abstract
Tobacco smoking is a known cause of gastric cancer, but several aspects of the association remain imprecisely quantified. We examined the relation between cigarette smoking and the risk of gastric cancer using a uniquely large dataset of 23 epidemiological studies within the 'Stomach cancer Pooling (StoP) Project', including 10 290 cases and 26 145 controls. We estimated summary odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) by pooling study-specific ORs using random-effects models. Compared with never smokers, the ORs were 1.20 (95% CI: 1.09-1.32) for ever, 1.12 (95% CI: 0.99-1.27) for former, and 1.25 (95% CI: 1.11-1.40) for current cigarette smokers. Among current smokers, the risk increased with number of cigarettes per day to reach an OR of 1.32 (95% CI: 1.10-1.58) for smokers of more than 20 cigarettes per day. The risk increased with duration of smoking, to reach an OR of 1.33 (95% CI: 1.14-1.54) for more than 40 years of smoking and decreased with increasing time since stopping cigarette smoking (P for trend<0.01) and became similar to that of never smokers 10 years after stopping. Risks were somewhat higher for cardia than noncardia gastric cancer. Risks were similar when considering only studies with information on Helicobacter pylori infection and comparing all cases to H. pylori+ controls only. This study provides the most precise estimate of the detrimental effect of cigarette smoking on the risk of gastric cancer on the basis of individual data, including the relationship with dose and duration, and the decrease in risk following stopping smoking.
Collapse
|
28
|
Bertuccio P, Alicandro G, Rota M, Pelucchi C, Bonzi R, Galeone C, Bravi F, Johnson KC, Hu J, Palli D, Ferraroni M, López‐Carrillo L, Lunet N, Ferro A, Malekzadeh R, Zaridze D, Maximovitch D, Vioque J, Navarrete‐Munoz EM, Pakseresht M, Hernández‐Ramírez RU, López‐Cervantes M, Ward M, Pourfarzi F, Tsugane S, Hidaka A, Zhang Z, Kurtz RC, Lagiou P, Lagiou A, Boffetta P, Boccia S, Negri E, La Vecchia C. Citrus fruit intake and gastric cancer: The stomach cancer pooling (StoP) project consortium. Int J Cancer 2019; 144:2936-2944. [PMID: 30521095 DOI: 10.1002/ijc.32046] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/14/2018] [Accepted: 11/21/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Paola Bertuccio
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Gianfranco Alicandro
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Matteo Rota
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Carlotta Galeone
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Francesca Bravi
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | - Kenneth C. Johnson
- School of Epidemiology, Public Health and Preventive MedicineUniversity of Ottawa Ottawa ON Canada
| | - Jinfu Hu
- Harbin Medical University Harbin China
| | - Domenico Palli
- Cancer Risk Factors and Life‐Style Epidemiology UnitInstitute for Cancer Research, Prevention and Clinical Network ‐ ISPRO Florence Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| | | | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação MédicaFaculdade de Medicina da Universidade do Porto Porto Portugal
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto Porto Portugal
| | - Ana Ferro
- EPIUnit – Instituto de Saúde Pública, Universidade do Porto Porto Portugal
| | - Reza Malekzadeh
- Digestive Oncology Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences Tehran Iran
| | - David Zaridze
- Department of Epidemiology and PreventionRussian N.N. Blokhin Cancer Research Center Moscow Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and PreventionRussian N.N. Blokhin Cancer Research Center Moscow Russia
| | - Jesus Vioque
- CIBER Epidemiologia y Salud Publica (CIBERESP) Madrid Spain
- Department of Public HealthMiguel Hernandez University, FISABIO‐ISABIAL Alicante Spain
| | - Eva M. Navarrete‐Munoz
- CIBER Epidemiologia y Salud Publica (CIBERESP) Madrid Spain
- Department of Public HealthMiguel Hernandez University, FISABIO‐ISABIAL Alicante Spain
| | - Mohammadreza Pakseresht
- Digestive Oncology Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences Tehran Iran
- Department of Agricultural, Food and Nutritional SciencesUniversity of Alberta Edmonton AB Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and BiostatisticsUniversity of Leeds Leeds United Kingdom
| | - Raúl U. Hernández‐Ramírez
- Mexico National Institute of Public Health Morelos Mexico
- Department of BiostatisticsYale School of Public Health, Yale School of Medicine New Haven CT USA
| | - Malaquias López‐Cervantes
- Dirección General de Planeación y Desarrollo en SaludSecretaría de Salud. Coyoacán 1501 Ciudad de México Mexico
| | - Mary Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer Institute Rockville MD USA
| | - Farhad Pourfarzi
- Digestive Oncology Research CenterDigestive Disease Research Institute, Tehran University of Medical Sciences Tehran Iran
- Digestive Disease Research CenterArdabil University of Medical Sciences Ardabil Iran
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health SciencesNational Cancer Center Tokyo Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health SciencesNational Cancer Center Tokyo Japan
| | - Zuo‐Feng Zhang
- Department of EpidemiologyUCLA Fielding School of Public Health and Jonsson, Comprehensive Cancer Center CA Los Angeles USA
| | - Robert C. Kurtz
- Department of MedicineMemorial Sloan Kettering Cancer Centre New York NY USA
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical StatisticsSchool of Medicine, National and Kapodistrian University of Athens Athens Greece
- Department of EpidemiologyHarvard T.H. Chan School of Public Health Boston MA USA
| | - Areti Lagiou
- Department of Public and Community HealthSchool of Health Sciences, University of West Attica Egaleo Greece
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai New York NY USA
| | - Stefania Boccia
- Università Cattolica del Sacro CuoreSezione di Igiene, Istituto di Sanità Pubblica Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCSUOC Igiene Ospedaliera Rome Italia
| | - Eva Negri
- Department of Biomedical and Clinical SciencesUniversità degli Studi di Milano Milan Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community HealthUniversità degli Studi di Milano Milan Italy
| |
Collapse
|
29
|
Xu Y, Yang J, Du L, Li K, Zhou Y. Association of whole grain, refined grain, and cereal consumption with gastric cancer risk: A meta-analysis of observational studies. Food Sci Nutr 2019; 7:256-265. [PMID: 30680179 PMCID: PMC6341150 DOI: 10.1002/fsn3.878] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 10/05/2018] [Accepted: 10/11/2018] [Indexed: 02/05/2023] Open
Abstract
Many studies have analyzed the relationship between cereal, whole, or refined grain and the risk of gastric cancer (GC) and have yielded mixed results. Therefore, we performed a meta-analysis of observational studies to summarize the available evidence on this topic. Databases such as PubMed, EMBASE, Web of Science, MEDLINE, and the Cochrane Library were searched for studies focusing on these associations from inception to October 2017. Summary odd ratios (OR) and 95% confidence intervals (CI) were calculated by using either a random- or fixed-effect model according to the between-studies heterogeneity. Subgroup analysis was also performed. In total, eleven studies that included 530,176 participants were identified. In a pooled analysis of all studies, cereal exposure was not associated with GC risk (OR, 1.11, 95%CI, 0.85-1.36). Specific analyses indicated that whole grain consumption was associated with decreased GC risk (OR, 0.61, 95%CI, 0.40-0.83) and that refined grain consumption was associated with increased GC risk (OR, 1.65, 95%CI, 1.36-1.94). Higher whole grain and lower refined grain intake but not cereal consumption reduces GC risk. This study has been registered at ClinicalTrials.gov (ID: NCT03419663).
Collapse
Affiliation(s)
- Yujie Xu
- West China School of Nursing and Department of NursingWest China HospitalSichuan UniversityChengduChina
| | - Jie Yang
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| | - Liang Du
- Chinese Evidence‐Based Medicine/Cochrane CenterChengduChina
| | - Ka Li
- Department of NursingWest China HospitalSichuan UniversityChengduChina
| | - Yong Zhou
- Department of Gastrointestinal SurgeryWest China HospitalSichuan UniversityChengduChina
| |
Collapse
|
30
|
Zhang K, Dai H, Liang W, Zhang L, Deng Z. Fermented dairy foods intake and risk of cancer. Int J Cancer 2018; 144:2099-2108. [PMID: 30374967 DOI: 10.1002/ijc.31959] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/24/2018] [Accepted: 10/09/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Kui Zhang
- Department of Forensic Pathology; West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University; Chengdu Sichuan People's Republic of China
| | - Hao Dai
- Department of Forensic Pathology; West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University; Chengdu Sichuan People's Republic of China
| | - Weibo Liang
- Department of Forensic Pathology; West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University; Chengdu Sichuan People's Republic of China
| | - Lin Zhang
- Department of Forensic Pathology; West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University; Chengdu Sichuan People's Republic of China
| | - Zhenhua Deng
- Department of Forensic Pathology; West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University; Chengdu Sichuan People's Republic of China
| |
Collapse
|
31
|
Adherence to Mediterranean diet and risk of gastric cancer: results of a case-control study in Italy. Eur J Cancer Prev 2018; 26:491-496. [PMID: 28542079 DOI: 10.1097/cej.0000000000000371] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study is to evaluate the association between adherence to Mediterranean diet (MD) and gastric cancer (GC). A case-control study was carried out at the Fondazione Policlinico 'A. Gemelli' (Rome, Italy) from 2003 to 2015. A total of 223 incident cases and 223 controls were interviewed. Dietary intake was assessed through a validated food frequency questionnaire that collected information on more than 25 food items. The association between adherence to MD and risk of GC was quantified by calculating Odds Ratios (OR) and 95% confidence intervals (CI). The analysis reports that a higher adherence to MD is associated with a reduced risk of GC (OR: 0.70; 95% CI: 0.61-0.81). A high consumption of vegetables (OR: 0.34; 95% CI: 0.14-0.85), legumes (OR: 0.13; 95% CI: 0.06-0.29), and fish (OR: 0.33; 95% CI: 0.15-0.68), as well as low consumption of meat (OR: 0.29; 95% CI: 0.10-0.85) and alcohol (OR: 0.46; 95% CI: 0.24-0.90) are consistently related to a lower risk of GC. Our study indicates a protective role of the MD eating pattern and MD individual components against GC. Our results showed a beneficial role of high vegetable, legume, and fish consumption, along with low intake of alcohol and meat in the development of GC.
Collapse
|
32
|
Ferro A, Morais S, Rota M, Pelucchi C, Bertuccio P, Bonzi R, Galeone C, Zhang ZF, Matsuo K, Ito H, Hu J, Johnson KC, Yu GP, Palli D, Ferraroni M, Muscat J, Malekzadeh R, Ye W, Song H, Zaridze D, Maximovitch D, Fernández de Larrea N, Kogevinas M, Vioque J, Navarrete-Muñoz EM, Pakseresht M, Pourfarzi F, Wolk A, Orsini N, Bellavia A, Håkansson N, Mu L, Pastorino R, Kurtz RC, Derakhshan MH, Lagiou A, Lagiou P, Boffetta P, Boccia S, Negri E, La Vecchia C, Peleteiro B, Lunet N. Alcohol intake and gastric cancer: Meta-analyses of published data versus individual participant data pooled analyses (StoP Project). Cancer Epidemiol 2018; 54:125-132. [PMID: 29727805 DOI: 10.1016/j.canep.2018.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Individual participant data pooled analyses allow access to non-published data and statistical reanalyses based on more homogeneous criteria than meta-analyses based on systematic reviews. We quantified the impact of publication-related biases and heterogeneity in data analysis and presentation in summary estimates of the association between alcohol drinking and gastric cancer. METHODS We compared estimates obtained from conventional meta-analyses, using only data available in published reports from studies that take part in the Stomach Cancer Pooling (StoP) Project, with individual participant data pooled analyses including the same studies. RESULTS A total of 22 studies from the StoP Project assessed the relation between alcohol intake and gastric cancer, 19 had specific data for levels of consumption and 18 according to cancer location; published reports addressing these associations were available from 18, 5 and 5 studies, respectively. The summary odds ratios [OR, (95%CI)] estimate obtained with published data for drinkers vs. non-drinkers was 10% higher than the one obtained with individual StoP data [18 vs. 22 studies: 1.21 (1.07-1.36) vs. 1.10 (0.99-1.23)] and more heterogeneous (I2: 63.6% vs 54.4%). In general, published data yielded less precise summary estimates (standard errors up to 2.6 times higher). Funnel plot analysis suggested publication bias. CONCLUSION Meta-analyses of the association between alcohol drinking and gastric cancer tended to overestimate the magnitude of the effects, possibly due to publication bias. Additionally, individual participant data pooled analyses yielded more precise estimates for different levels of exposure or cancer subtypes.
Collapse
Affiliation(s)
- Ana Ferro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal
| | - Matteo Rota
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Claudio Pelucchi
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Carlotta Galeone
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Hidemi Ito
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Jinfu Hu
- Department of Epidemiology, Harbin Medical University, Harbin, China
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Joshua Muscat
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Huan Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Nerea Fernández de Larrea
- Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jesus Vioque
- Miguel Hernandez University and ISABIAL-FISABIO Foundation, Campus San Juan, Alicante, Spain
| | - Eva M Navarrete-Muñoz
- Miguel Hernandez University and ISABIAL-FISABIO Foundation, Campus San Juan, Alicante, Spain
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada; Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala Sweden
| | - Nicola Orsini
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Bellavia
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Roberta Pastorino
- Section of Hygiene - Institute of Public Health; Università Cattolica del Sacro Cuore, IRCCS Fondazione Policlinico "Agostino Gemelli", L.go F. Vito, 1 - 00168, Rome, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Mohammad H Derakhshan
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, United Kingdom; Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Areti Lagiou
- Department of Public Health and Community Health, School of Health Professions, Athens Technological Educational Institute, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefania Boccia
- Section of Hygiene - Institute of Public Health; Università Cattolica del Sacro Cuore, IRCCS Fondazione Policlinico "Agostino Gemelli", L.go F. Vito, 1 - 00168, Rome, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Bárbara Peleteiro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| |
Collapse
|
33
|
Rosato V, Kawakita D, Negri E, Serraino D, Garavello W, Montella M, Decarli A, La Vecchia C, Ferraroni M. Processed meat and risk of selected digestive tract and laryngeal cancers. Eur J Clin Nutr 2018; 73:141-149. [DOI: 10.1038/s41430-018-0153-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 02/23/2018] [Accepted: 03/02/2018] [Indexed: 12/16/2022]
|
34
|
Milk/dairy products consumption and gastric cancer: an update meta-analysis of epidemiological studies. Oncotarget 2017; 9:7126-7135. [PMID: 29467955 PMCID: PMC5805541 DOI: 10.18632/oncotarget.23496] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 10/12/2017] [Indexed: 12/16/2022] Open
Abstract
The relationship between dairy consumption and gastric cancer risk has not been well studied. We therefore performed a update meta-analysis to evaluate the relationship. Published cohort and case-control studies were identified via computer searches and reviewing the reference lists of the key articles. Random effects meta-analysis was used to pool effects from 5 cohort and 29 case-control studies. The odds ratio for the overall association between dairy consumption and gastric cancer was 1.20 (95%confidence interval: 1.04–1.39). The combined risk estimate was similar for population-based case-control studies (odds ratio = 1.27, 95%confidence interval: 1.00–1.61), but was reduced for hospital-based studies (odds ratio = 1.22; 95%confidence interval: 0.95–1.57) and cohort studies (odds ratio = 0.99; 95%confidence interval: 0.77–1.28). There was high heterogeneity in overall analyses. In the population-based subgroup analyses, the odds ratio was 0.96 (95%confidence interval: 0.69–1.34) when considering five studies assessing exposure two or more years before interview, and the association strengthened (odds ratio = 1.91, 95%confidence interval: 1.60–2.28) when dairy consumption was evaluated one year or less prior to interview. In conclusion, we found adverse effect of dairy consumption associated with gastric cancer.
Collapse
|
35
|
Rota M, Pelucchi C, Bertuccio P, Matsuo K, Zhang ZF, Ito H, Hu J, Johnson KC, Palli D, Ferraroni M, Yu GP, Muscat J, Lunet N, Peleteiro B, Ye W, Song H, Zaridze D, Maximovitch D, Guevara M, Fernández-Villa T, Vioque J, Navarrete-Muñoz EM, Wolk A, Orsini N, Bellavia A, Håkansson N, Mu L, Persiani R, Kurtz RC, Lagiou A, Lagiou P, Galeone C, Bonzi R, Boffetta P, Boccia S, Negri E, La Vecchia C. Alcohol consumption and gastric cancer risk-A pooled analysis within the StoP project consortium. Int J Cancer 2017; 141:1950-1962. [PMID: 28718913 DOI: 10.1002/ijc.30891] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/22/2017] [Accepted: 05/29/2017] [Indexed: 01/11/2023]
Abstract
An association between heavy alcohol drinking and gastric cancer risk has been recently reported, but the issue is still open to discussion and quantification. We investigated the role of alcohol drinking on gastric cancer risk in the "Stomach cancer Pooling (StoP) Project," a consortium of epidemiological studies. A total of 9,669 cases and 25,336 controls from 20 studies from Europe, Asia and North America were included. We estimated summary odds-ratios (ORs) and the corresponding 95% confidence intervals (CIs) by pooling study-specific ORs using random-effects meta-regression models. Compared with abstainers, drinkers of up to 4 drinks/day of alcohol had no increase in gastric cancer risk, while the ORs were 1.26 (95% CI, 1.08-1.48) for heavy (>4 to 6 drinks/day) and 1.48 (95% CI 1.29-1.70) for very heavy (>6 drinks/day) drinkers. The risk for drinkers of >4 drinks/day was higher in never smokers (OR 1.87, 95% CI 1.35-2.58) as compared with current smokers (OR 1.14, 95% CI 0.93-1.40). Somewhat stronger associations emerged with heavy drinking in cardia (OR 1.61, 95% CI 1.11-2.34) than in non-cardia (OR 1.28, 95% CI 1.13-1.45) gastric cancers, and in intestinal-type (OR 1.54, 95% CI 1.20-1.97) than in diffuse-type (OR 1.29, 95% CI 1.05-1.58) cancers. The association was similar in strata of H. pylori infected (OR = 1.52, 95% CI 1.16-2.00) and noninfected subjects (OR = 1.69, 95% CI 0.95-3.01). Our collaborative pooled-analysis provides definite, more precise quantitative evidence than previously available of an association between heavy alcohol drinking and gastric cancer risk.
Collapse
Affiliation(s)
- Matteo Rota
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.,Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Claudio Pelucchi
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Paola Bertuccio
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA
| | - Hidemi Ito
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Jinfu Hu
- Department of Epidemiology, Harbin Medical University, Harbin, China
| | - Kenneth C Johnson
- School of Epidemiology, Public Health and Preventive Medicine (SEPHPM), University of Ottawa, ON, Canada
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Joshua Muscat
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Penn Sylvania State University College of Medicine, Hershey, PA
| | - Nuno Lunet
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal.,Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Bárbara Peleteiro
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal.,Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina, Universidade do Porto, Portugal
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Huan Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Marcela Guevara
- Public Health Institute of Navarra, IdiSNA, Pamplona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain
| | - Tania Fernández-Villa
- Research Group on Gene-Environment Interactions (GIGAS), University of Leòn, Leòn, Spain
| | - Jesus Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain.,Department of Public Health, Miguel Hernandez University, Campus San Juan, Alicante, Spain
| | - Eva M Navarrete-Muñoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain.,Department of Public Health, Miguel Hernandez University, Campus San Juan, Alicante, Spain
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nicola Orsini
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Bellavia
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Niclas Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, NY
| | - Roberto Persiani
- Department of Surgical Sciences, Division of General Surgery, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli", Rome, Italy
| | - Robert C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Centre, NY
| | - Areti Lagiou
- Department of Public Health and Community Health, School of Health Professions, Athens Technological Educational Institute, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Carlotta Galeone
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Rossella Bonzi
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Paolo Boffetta
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, NY
| | - Stefania Boccia
- Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli,", Rome, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Italy
| |
Collapse
|
36
|
Shivappa N, Hébert JR, Ferraroni M, La Vecchia C, Rossi M. Association between Dietary Inflammatory Index and Gastric Cancer Risk in an Italian Case-Control Study. Nutr Cancer 2016; 68:1262-1268. [PMID: 27636679 PMCID: PMC5154551 DOI: 10.1080/01635581.2016.1224367] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND In this study, we explored the association between the dietary inflammatory index (DII) and gastric cancer risk in an Italian case-control study. MATERIALS AND METHODS Cases were 230 patients with incident, histologically confirmed cases of gastric cancer from the Greater Milan area, Northern Italy. Controls were 547 frequency-matched subjects admitted to the same network of hospitals as cases for a wide spectrum of acute, non-neoplastic conditions. The DII was computed using a reproducible and valid 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models conditioned on age and sex and adjusted for recognized confounding factors, including total energy intake. RESULTS Subjects with the most pro-inflammatory diet had a higher risk of gastric cancer compared to subjects with the most anti-inflammatory diet (ORQuartile4vs1 = 2.35, 95% confidence interval, 1.32, 4.20; P-trend = 0.004). CONCLUSION These results indicate that a pro-inflammatory diet, as indicated by higher DII score, was associated with increased risk of gastric cancer.
Collapse
Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, 29229, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, 29229, USA
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina, 29208, USA
| | - Monica Ferraroni
- Department of Clinical Sciences and Community Health. Universitá degli Studi di Milano, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health. Universitá degli Studi di Milano, Milan, Italy
| | - Marta Rossi
- Department of Clinical Sciences and Community Health. Universitá degli Studi di Milano, Milan, Italy
| |
Collapse
|
37
|
Mishra A, Ahmed K, Froghi S, Dasgupta P. Systematic review of the relationship between artificial sweetener consumption and cancer in humans: analysis of 599,741 participants. Int J Clin Pract 2015. [PMID: 26202345 DOI: 10.1111/ijcp.12703] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The effect of artificial sweetener consumption on cancer risk has been debated in animal models for over four decades. To further investigate this relationship, this study aims to synthesise results from several of the most recent studies in humans. METHODS An online literature search was performed in MEDLINE from 2003 to 2014 using Ovid, PubMed, Web of Science, and Scopus using keywords 'artificial', 'sweetener' and 'cancer'. Ninety-two results were then manually assessed for eligibility. Studies were included if the relationship between artificial sweeteners and cancer was their central hypothesis, and if they adjusted for age, gender, smoking status and body mass index. Extracted data included study design, patient characteristics, outcome measure and results. RESULTS In the five publications that satisfied the inclusion criteria, significant direct associations with artificial consumption were found for laryngeal (odds ratio, OR 2.34, 95% CI: 1.20-4.55), urinary tract tumours (OR 2.12, 95% CI: 1.22-3.89), non-Hodgkin lymphoma in men (RR 1.31, 95% CI: 1.01-1.72), multiple myeloma in men (RR 2.02, 95% CI: 1.20-3.40) and leukaemia (RR 1.42, 95% CI: 1.00-2.02). Inverse relationships were found in breast (OR 0.70, 95% CI: 0.54-0.91, p trend = 0.015) and ovarian (OR 0.56, 95% CI: 0.38-0.81, p trend < 0.001) cancers. CONCLUSION The statistical value of this review is limited by the heterogeneity and observational designs of the included studies. Although there is limited evidence to suggest that heavy consumption may increase the risk of certain cancers, overall the data presented are inconclusive as to any relationship between artificial sweeteners and cancer.
Collapse
Affiliation(s)
- A Mishra
- GKT School of Medical Education, King's College London, London, UK
| | - K Ahmed
- MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK
| | - S Froghi
- MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK
| | - P Dasgupta
- MRC Centre for Transplantation, NIHR Biomedical Research Centre, King's Health Partners, Guy's and St. Thomas' Hospitals, London, UK
| |
Collapse
|
38
|
Abstract
High intakes of fruit and vegetables may reduce the risk of cancer at several sites. Evidence has been derived mainly from case-control studies. We reviewed the relationship between consumption of vegetables and fruit and the risk of several common cancers in a network of Italian and Swiss case-control studies including over 10,000 cases of fourteen different cancers and about 17,000 controls. Data were suggestive of a protective role of vegetable intake on the risk of several common epithelial cancers. OR for the highest compared with the lowest levels of consumption ranged from 0.2 (larynx, oral cavity and pharynx) to 0.9 (prostate). Inverse associations were found for both raw and cooked vegetables, although for upper digestive tract cancers the former were somewhat stronger. Similar inverse associations were found for cruciferous vegetables. Frequent consumption of allium vegetables was also associated with reduced risk of several cancers. Fruit was a favourable correlate of the risk of several cancers, particularly of the upper digestive tract, with associations generally weaker than those reported for vegetables. A reduced risk of cancers of the digestive tract and larynx was found for high consumption of citrus fruit. Suggestive protections against several forms of cancer, mainly digestive tract cancers, were found for high consumption of apples and tomatoes. High intakes of fibres, flavonoids and proanthocyanidins were inversely related to various forms of cancer. In conclusion, data from our series of case-control studies suggested a favourable role of high intakes of fruit and vegetables in the risk of many common cancers, particularly of the digestive tract. This adds evidence to the indication that aspects of the Mediterranean diet may have a favourable impact not only on CVD, but also on several common (epithelial) cancers, particularly of the digestive tract.
Collapse
|
39
|
Praud D, Parpinel M, Serafini M, Bellocco R, Tavani A, Lagiou P, La Vecchia C, Rossi M. Non-enzymatic antioxidant capacity and risk of gastric cancer. Cancer Epidemiol 2015; 39:340-5. [PMID: 25936460 DOI: 10.1016/j.canep.2015.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 04/03/2015] [Accepted: 04/04/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Consumption of fruit and vegetables has been inversely related to gastric cancer. Two studies found that dietary antioxidant capacity has some role in explaining this association. We investigated the overall antioxidant effect from diet on gastric cancer using three measures of non-enzymatic antioxidant capacity (NEAC). METHODS We used data from an Italian case-control study including 230 patients with incident, histologically confirmed gastric cancer, and 547 frequency matched controls admitted to the same hospitals for acute non-neoplastic diseases. A reproducible and valid food frequency questionnaire was used to assess subjects' usual diet. NEAC was measured using Italian food composition tables in terms of Trolox equivalent antioxidant capacity (TEAC), Ferric reducing-antioxidant power (FRAP) and Total radical-trapping antioxidant parameter (TRAP). We estimated the odds ratios (OR) of gastric cancer and the corresponding 95% confidence intervals (CI) using conditional logistic regression models including terms for recognized gastric cancer risk factors and total energy intake. RESULTS NEAC was inversely related with gastric cancer risk with ORs for the highest versus the lowest quintile of 0.54 (95%CI, 0.33-0.88) for TEAC, 0.67 (95%CI, 0.42-1.07) for FRAP and 0.57 (95%CI, 0.36-0.90) for TRAP. CONCLUSIONS A diet rich in antioxidant capacity reduced gastric cancer risk, suggesting a high consumption of fruit and vegetables and a moderate consumption of wine and whole cereals.
Collapse
Affiliation(s)
- Delphine Praud
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via G. Venezian 1, 20133 Milan, Italy
| | - Maria Parpinel
- Unit of Hygiene and Epidemiology, Department of Biological and Medical Sciences, University of Udine, via Palladio 8, 33100 Udine, Italy
| | - Mauro Serafini
- Functional Food and Metabolic Stress Prevention Laboratory, Research Center on Agriculture, CRA-NUT, via Ardeatina 546, 00178 Rome, Italy
| | - Rino Bellocco
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden
| | - Alessandra Tavani
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, 20156 Milan, Italy
| | - Pagona Lagiou
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, 75 M Asias Street, Goudi GR-115-27 Athens, Greece
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via G. Venezian 1, 20133 Milan, Italy
| | - Marta Rossi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via G. Venezian 1, 20133 Milan, Italy; Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, 20156 Milan, Italy.
| |
Collapse
|
40
|
Sun Y, Lin LJ, Sang LX, Dai C, Jiang M, Zheng CQ. Dairy product consumption and gastric cancer risk: A meta-analysis. World J Gastroenterol 2014; 20:15879-15898. [PMID: 25400475 PMCID: PMC4229556 DOI: 10.3748/wjg.v20.i42.15879] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 04/02/2014] [Accepted: 06/26/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate whether dairy product consumption is a risk factor for gastric cancer.
METHODS: We searched the PubMed and Web of Science databases for English-language studies on dairy product consumption and gastric cancer risk that were published between October 1980 and September 2013. One author independently extracted data and assessed study quality. Based on the heterogeneity results, we used either the fixed effects model or the random effects model to compute the summary relative risks and 95% confidence intervals (CIs). We also analyzed subgroups according to the study design, geographic region, sex, and whether there were adjustments for confounders (smoking and drinking) with respect to the sources of heterogeneity.
RESULTS: We found 39 studies that were potentially eligible for inclusion in this meta-analysis, including 10 cohort studies and 29 case-control studies. The summary relative risk for gastric cancer, comparing the highest and lowest dairy product consumption categories, was 1.06 (95%CI: 0.95-1.18). Specific analyses for milk, butter, and margarine yielded similar results, but the results for cheese and yogurt were different. There was significant heterogeneity for all studies (Q = 112.61; P = 0.000; I2 = 67.1%). No publication bias was observed (Egger’s test: P = 0.135; Begg’s test: P = 0.365). There was a nonsignificant association between dairy product consumption and gastric cancer risk in the subgroup analysis for the study design, sex, geographic region, and whether there were adjustments for confounders (smoking and drinking).
CONCLUSION: In our meta-analysis, dairy product consumption was associated with a nonsignificantly increased risk of gastric cancer. However, this result should be verified using large, well-designed prospective studies.
Collapse
|
41
|
Turati F, Pelucchi C, Guercio V, Vecchia CL, Galeone C. Allium vegetable intake and gastric cancer: A case-control study and meta-analysis. Mol Nutr Food Res 2014; 59:171-9. [DOI: 10.1002/mnfr.201400496] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/04/2014] [Accepted: 09/08/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Federica Turati
- Department of Epidemiology; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri; Milano Italy
| | - Claudio Pelucchi
- Department of Epidemiology; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri; Milano Italy
| | - Valentina Guercio
- Department of Clinical Sciences and Community Health; Università degli Studi di Milano; Milan Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health; Università degli Studi di Milano; Milan Italy
| | - Carlotta Galeone
- Department of Epidemiology; IRCCS - Istituto di Ricerche Farmacologiche Mario Negri; Milano Italy
| |
Collapse
|
42
|
Guercio V, Galeone C, Turati F, La Vecchia C. Gastric cancer and allium vegetable intake: a critical review of the experimental and epidemiologic evidence. Nutr Cancer 2014; 66:757-73. [PMID: 24820444 DOI: 10.1080/01635581.2014.904911] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
There are suggestions of an anticancerogenic effect of allium vegetables and their associated organosulfur components against several cancer types, including gastric cancer, but the issue remains open to discussion and quantification. The present critical review discussed the history, the health properties, the chemistry, the anticancerogenic evidences from experimental studies, and the anticancer mechanisms of allium vegetables. We also summarized findings from epidemiological studies concerning the association between different types of allium vegetables and gastric cancer risk, published up to date. Available data, derived mainly from case-control studies, suggested a favorable role of high intakes of allium vegetables, mainly garlic and onion, in the etiology of gastric cancer. In particular, of 10 studies, 7 suggested a favorable role of high intake of total allium vegetables and gastric cancer. All 14 studies on garlic and most studies on onion (more than 80%) reported a beneficial role of these allium types against gastric cancer. However several limitations, including possible publication bias and the difficulty to establish a dose-risk relationship, suggest caution in the interpretation. Evidences on other types of allium vegetables, as well as on the influence of different gastric cancer anatomical and histological types, are less consistent.
Collapse
|
43
|
Praud D, Bertuccio P, Bosetti C, Turati F, Ferraroni M, La Vecchia C. Adherence to the Mediterranean diet and gastric cancer risk in Italy. Int J Cancer 2013; 134:2935-41. [PMID: 24259274 DOI: 10.1002/ijc.28620] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/04/2013] [Indexed: 02/06/2023]
Abstract
We investigated gastric cancer risk in relation to the adherence to the Mediterranean diet using data from two case-control studies conducted in Italy between 1985 and 2007, including 999 incidents, histologically confirmed gastric cancers and 2,628 controls admitted to hospital for acute non-neoplastic diseases. Adherence to the Mediterranean diet was assessed using the Mediterranean Diet Score (MDS) based on nine of the major characteristics of the Mediterranean diet in the overall dataset. The Mediterranean Dietary Pattern adherence index (MDP) and the Mediterranean Adequacy Index (MAI) were considered in the second study only. We estimated odds ratios (OR) and corresponding 95% confidence intervals (CI) of gastric cancer for categories of the three scores using multiple logistic regression models. We found a reduced risk of gastric cancer for increasing levels of the MDS: as compared to subjects in the lowest category of the MDS, the ORs were 0.78, 0.61 and 0.57 in subsequent levels of MDS, with a significant trend in risk. Risk estimates were consistent across strata of age, sex, education, smoking, body mass index, and family history of gastric cancer. We also observed a decreased risk of gastric cancer for the highest versus the lowest quintile for MDP and MAI, with OR of 0.58 and 0.71, respectively. Our study provides convincing evidence of a beneficial role of the Mediterranean diet on gastric cancer.
Collapse
Affiliation(s)
- Delphine Praud
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | | | | | | | | | | |
Collapse
|
44
|
Di Maso M, Talamini R, Bosetti C, Montella M, Zucchetto A, Libra M, Negri E, Levi F, La Vecchia C, Franceschi S, Serraino D, Polesel J. Red meat and cancer risk in a network of case-control studies focusing on cooking practices. Ann Oncol 2013; 24:3107-12. [PMID: 24121119 DOI: 10.1093/annonc/mdt392] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Consumption of red meat has been related to increased risk of several cancers. Cooking methods could modify the magnitude of this association, as production of chemicals depends on the temperature and duration of cooking. METHODS We analyzed data from a network of case-control studies conducted in Italy and Switzerland between 1991 and 2009. The studies included 1465 oral and pharyngeal, 198 nasopharyngeal, 851 laryngeal, 505 esophageal, 230 stomach, 1463 colon, 927 rectal, 326 pancreatic, 3034 breast, 454 endometrial, 1031 ovarian, 1294 prostate and 767 renal cancer cases. Controls included 11 656 patients admitted for acute, non-neoplastic conditions. Odds ratios (ORs) and confidence intervals (CIs) were estimated by multiple logistic regression models, adjusted for known confounding factors. RESULTS Daily intake of red meat was significantly associated with the risk of cancer of the oral cavity and pharynx (OR for increase of 50 g/day = 1.38; 95% CI: 1.26-1.52), nasopharynx (OR = 1.29; 95% CI: 1.04-1.60), larynx (OR = 1.46; 95% CI: 1.30-1.64), esophagus (OR = 1.46; 95% CI: 1.23-1.72), colon (OR = 1.17; 95% CI: 1.08-1.26), rectum (OR = 1.22; 95% CI:1.11-1.33), pancreas (OR = 1.51; 95% CI: 1.25-1.82), breast (OR = 1.12; 95% CI: 1.04-1.19), endometrium (OR = 1.30; 95% CI: 1.10-1.55) and ovary (OR = 1.29; 95% CI: 1.16-1.43). Fried meat was associated with a higher risk of cancer of oral cavity and pharynx (OR = 2.80; 95% CI: 2.02-3.89) and esophagus (OR = 4.52; 95% CI: 2.50-8.18). Risk of prostate cancer increased for meat cooked by roasting/grilling (OR = 1.31; 95% CI: 1.12-1.54). No heterogeneity according to cooking methods emerged for other cancers. Nonetheless, significant associations with boiled/stewed meat also emerged for cancer of the nasopharynx (OR = 1.97; 95% CI: 1.30-3.00) and stomach (OR = 1.86; 95% CI: 1.20-2.87). CONCLUSIONS Our analysis confirmed red meat consumption as a risk factor for several cancer sites, with a limited impact of cooking methods. These findings, thus, call for a limitation of its consumption in populations of Western countries.
Collapse
Affiliation(s)
- M Di Maso
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
This study uses Swedish occupational register data to examine whether the proportion of men in administrative workplaces in the Swedish public service affects all-cause mortality risks amongst both males and females of working age. Using piecewise constant survival models to analyse occupational data from the Swedish administrative registers from 1995 to 2007, it was found that for males, a 1% increase in the proportion of males was associated with a 1.3% increase in mortality risk (hazard ratio, HR 1.013, 95% CI 1.007-1.020, p<0.001), but no association was found for females (HR 1.004, 95% CI 0.996-1.012, p=0.297). Adjustments were made for age, family status, education, occupational status, occupational segregation by sex, the total number of individuals in the workplace, level of government, region, period and variables reflecting the workplace structure by age, age by sex, occupation and education. A higher proportion of males may be related to (i) an increased exposure to risky health behaviours such as alcohol consumption and unhealthy dietary patterns, (ii) a tendency towards sickness presenteeism, and (iii) an increase in the levels of several well-established emotional stressors in the workplace, leading to an increased level of psychosocial stress. The findings and potential extensions of this research are discussed.
Collapse
|
46
|
Tavani A, Malerba S, Pelucchi C, Dal Maso L, Zucchetto A, Serraino D, Levi F, Montella M, Franceschi S, Zambon A, La Vecchia C. Dietary folates and cancer risk in a network of case-control studies. Ann Oncol 2012; 23:2737-2742. [PMID: 22898036 DOI: 10.1093/annonc/mds212] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Folate deficiency leads to DNA damage and inadequate repair, caused by a decreased synthesis of thymidylate and purines. We analyzed the relationship between dietary folate intake and the risk of several cancers. PATIENTS AND METHODS The study is based on a network of case-control studies conducted in Italy and Switzerland in 1991-2009. The odds ratios (ORs) for dietary folate intake were estimated by multiple logistic regression models, adjusted for major identified confounding factors. RESULTS For a few cancer sites, we found a significant inverse relation, with ORs for an increment of 100 μg/day of dietary folate of 0.65 for oropharyngeal (1467 cases), 0.58 for esophageal (505 cases), 0.83 for colorectal (2390 cases), 0.72 for pancreatic (326 cases), 0.67 for laryngeal (851 cases) and 0.87 for breast (3034 cases) cancers. The risk estimates were below unity, although not significantly, for cancers of the endometrium (OR = 0.87, 454 cases), ovary (OR = 0.86, 1031 cases), prostate (OR = 0.91, 1468 cases) and kidney (OR = 0.88, 767 cases), and was 1.00 for stomach cancer (230 cases). No material heterogeneity was found in strata of sex, age, smoking and alcohol drinking. CONCLUSIONS Our data support a real inverse association of dietary folate intake with the risk of several common cancers.
Collapse
Affiliation(s)
- A Tavani
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan.
| | - S Malerba
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan
| | - C Pelucchi
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan
| | - L Dal Maso
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (Pordenone), Italy
| | - A Zucchetto
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (Pordenone), Italy
| | - D Serraino
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (Pordenone), Italy
| | - F Levi
- Cancer Epidemiology Unit and Registre Vaudois des Tumeurs, Institut universitaire de médecine sociale et préventive, Lausanne, Switzerland
| | - M Montella
- Unit of Epidemiology, Istituto Tumori 'Fondazione Pascale', Naples, Italy
| | - S Franceschi
- International Agency for Research on Cancer, Lyon, France
| | - A Zambon
- Department of Statistics, Unit of Biostatistics and Epidemiology, University of Milano-Bicocca, Milan
| | - C La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan; Department of Clinical Sciences and Public Health, University of Milan, Milan, Italy
| |
Collapse
|
47
|
Tavani A, Rosato V, Di Palma F, Bosetti C, Talamini R, Dal Maso L, Zucchetto A, Levi F, Montella M, Negri E, Franceschi S, La Vecchia C. History of cholelithiasis and cancer risk in a network of case-control studies. Ann Oncol 2012; 23:2173-2178. [PMID: 22231026 DOI: 10.1093/annonc/mdr581] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND We analyzed the relationship between cholelithiasis and cancer risk in a network of case-control studies conducted in Italy and Switzerland in 1982-2009. METHODS The analyses included 1997 oropharyngeal, 917 esophageal, 999 gastric, 23 small intestinal, 3726 colorectal, 684 liver, 688 pancreatic, 1240 laryngeal, 6447 breast, 1458 endometrial, 2002 ovarian, 1582 prostate, 1125 renal cell, 741 bladder cancers, and 21 284 controls. The odds ratios (ORs) were estimated by multiple logistic regression models. RESULTS The ORs for subjects with history of cholelithiasis compared with those without were significantly elevated for small intestinal (OR=3.96), prostate (OR=1.36), and kidney cancers (OR=1.57). These positive associations were observed ≥10 years after diagnosis of cholelithiasis and were consistent across strata of age, sex, and body mass index. No relation was found with the other selected cancers. A meta-analysis including this and three other studies on the relation of cholelithiasis with small intestinal cancer gave a pooled relative risk of 2.35 [95% confidence interval (CI) 1.82-3.03]. CONCLUSION In subjects with cholelithiasis, we showed an appreciably increased risk of small intestinal cancer and suggested a moderate increased risk of prostate and kidney cancers. We found no material association with the other cancers considered.
Collapse
Affiliation(s)
- A Tavani
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan.
| | - V Rosato
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan
| | - F Di Palma
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan
| | - C Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan
| | - R Talamini
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano
| | - L Dal Maso
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano; Department of Occupational Health, University of Milan, Milan, Italy
| | - A Zucchetto
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano
| | - F Levi
- Cancer Epidemiology Unit and Registre Vaudois des Tumeurs, Institut universitaire de médecine sociale et préventive, Lausanne, Switzerland
| | - M Montella
- Unit of Epidemiology, Istituto Tumori "Fondazione Pascale", Naples, Italy
| | - E Negri
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan
| | - S Franceschi
- International Agency for Research on Cancer, Lyon
| | - C La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche "Mario Negri", Milan; Department of Occupational Health, University of Milan, Milan, Italy; International Prevention Research Institute, Lyon, France
| |
Collapse
|
48
|
Bosetti C, Filomeno M, Riso P, Polesel J, Levi F, Talamini R, Montella M, Negri E, Franceschi S, La Vecchia C. Cruciferous vegetables and cancer risk in a network of case-control studies. Ann Oncol 2012; 23:2198-2203. [PMID: 22328735 DOI: 10.1093/annonc/mdr604] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cruciferous vegetables have been suggested to protect against various cancers, though the issue is open to discussion. To further understand their role, we analyzed data from a network of case-control studies conducted in Italy and Switzerland. PATIENTS AND METHODS The studies included a total of 1468 cancers of the oral cavity/pharynx, 505 of the esophagus, 230 of the stomach, 2390 of the colorectum, 185 of the liver, 326 of the pancreas, 852 of the larynx, 3034 of the breast, 367 of the endometrium, 1031 of the ovary, 1294 of the prostate, 767 of the kidney, and 11,492 controls. All cancers were incident, histologically confirmed; controls were subjects admitted to the same network of hospitals as cases for a wide spectrum of acute nonneoplastic conditions. RESULTS The multivariate odds ratio (OR) for consumption of cruciferous vegetables at least once a week as compared with no/occasional consumption was significantly reduced for cancer of the oral cavity/pharynx (OR=0.83), esophagus (OR=0.72), colorectum (OR=0.83), breast (OR=0.83), and kidney (OR=0.68). The OR was below unity, but not significant, for stomach (OR=0.90), liver (OR=0.72), pancreatic (OR=0.90), laryngeal (OR=0.84), endometrial (OR=0.93), ovarian (OR=0.91), and prostate (OR=0.87) cancer. CONCLUSION This large series of studies provides additional evidence of a favorable effect of cruciferous vegetables on several common cancers.
Collapse
Affiliation(s)
- C Bosetti
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan.
| | - M Filomeno
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan
| | - P Riso
- Department of Food Science and Microbiology, Division of Human Nutrition, University of Milan, Milan
| | - J Polesel
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (Pordenone), Italy
| | - F Levi
- Cancer Epidemiology Unit and Registre Vaudois des Tumeurs, Institut universitaire de médecine sociale et préventive, Lausanne, Switzerland
| | - R Talamini
- Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, Aviano (Pordenone), Italy
| | - M Montella
- Unit of Epidemiology, Istituto Tumori 'Fondazione Pascale', Naples, Italy
| | - E Negri
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan
| | - S Franceschi
- International Agency for Research on Cancer, Lyon, France
| | - C La Vecchia
- Department of Epidemiology, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan; Department of Occupational Health, University of Milan, Milan, Italy
| |
Collapse
|
49
|
Bosetti C, Rosato V, Polesel J, Levi F, Talamini R, Montella M, Negri E, Tavani A, Zucchetto A, Franceschi S, Corrao G, Vecchia CL. Diabetes Mellitus and Cancer Risk in a Network of Case-Control Studies. Nutr Cancer 2012; 64:643-51. [DOI: 10.1080/01635581.2012.676141] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
50
|
Williams PG. Evaluation of the evidence between consumption of refined grains and health outcomes. Nutr Rev 2012; 70:80-99. [DOI: 10.1111/j.1753-4887.2011.00452.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|