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Pelucchi C, La Vecchia C, Bonzi R, Negri E, Corso G, Boccia S, Boffetta P, Camargo MC, Curado MP, Lunet N, Vioque J, Zhang ZF. The global gastric cancer consortium: an update from the Stomach cancer Pooling (StoP) project. Eur J Cancer Prev 2024; 33:433-437. [PMID: 38373049 DOI: 10.1097/cej.0000000000000874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
We updated to December 2023 the main findings of the stomach cancer pooling (StoP) project including about 13 000 cases and 31 000 controls from 29 case-control and 5 nested studies. The StoP project quantified more precisely than previously available the positive associations of tobacco smoking, high alcohol consumption, meat intake, selected occupations (e.g. agricultural and miners), gastric ulcer and family history with gastric cancer and the inverse associations with socioeconomic status and selected aspects of diet (fruits, including citrus fruits, vegetables, including allium and mushrooms, and polyphenols). No consistent associations were found with coffee, yoghurt and leisure-time physical activity, metformin or proton pump inhibitors use.
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Affiliation(s)
- 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
| | - 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
| | - 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
| | - Eva Negri
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Corso
- Division of Breast Surgery, IEO European Institute of Oncology IRCCS
- European Cancer Prevention Organization (ECP)
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefania Boccia
- Section of Hygiene, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, 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
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Maria Paula Curado
- Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brasil
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR)
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Jesus Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernandez (ISABIAL-UMH), Alicante, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
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Cao L, Zhu G, Wang X, Kuang Z, Song X, Ma X, Zhu X, Gao R, Li J. Yiqi Wenyang Jiedu prescription for preventing and treating postoperative recurrence and metastasis of gastric cancer: a randomized controlled trial protocol. Front Oncol 2024; 14:1326970. [PMID: 39035732 PMCID: PMC11257841 DOI: 10.3389/fonc.2024.1326970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 06/17/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Postoperative recurrence and metastasis of gastric cancer (GC) are primary factors that contribute to poor prognosis. GC recurs at a rate of approximately 70%-80% within 2 years after local treatment and approximately 90% within 5 years. "Yang-deficient toxic node" is the core pathogenesis of GC recurrence and metastasis. The Yiqi Wenyang Jiedu prescription (YWJP), a form of complementary and alternative medicine in China, is an empirical remedy to prevent postoperative recurrence and metastasis of GC. Taking the main therapeutic principles of "nourishing Qi and warming Yang, strengthening Zhengqi, and detoxifying" can aid in preventing the recurrence and metastasis of GC in patients during the watchful waiting period after surgery and adjuvant chemotherapy. This approach aims to enhance the quality of life of patients. However, high-quality evidence to support this hypothesis is lacking. This study will aim to investigate the efficacy and safety of YWJP to prevent and treat postoperative metastasis and GC recurrence. Methods The study will be a multicenter, randomized, double-blind, placebo-parallel-controlled clinical trial. A total of 212 patients who completed adjuvant chemotherapy within 8 months of radical gastrectomy will be enrolled. Patients in the intervention group will receive the YWJP, whereas those in the control group will receive a placebo. The main outcome was the disease-free survival (DFS) rate 2 years after surgery. The secondary outcomes included DFS time, overall survival, annual cumulative recurrence and rate of metastasis after 1-3 years, cumulative annual survival after 1-3 years, fat distribution-related indicators, tumor markers, peripheral blood inflammatory indicators, prognostic nutritional index, symptoms and quality of life evaluation, medication compliance, and adverse reaction rate. Discussion There is a lack of effective therapy after the completion of adjuvant therapy during the postoperative period of watchful waiting. This study will be the first randomized clinical trial to evaluate whether complementary and alternative medical interventions can effectively prevent recurrence and metastasis during the watchful waiting period after GC surgery and to provide evidence for surveillance treatment management after GC surgery. Clinical trial registration ClinicalTrials.gov, identifier NCT05229809.
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Affiliation(s)
- Luchang Cao
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guanghui Zhu
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Xinmiao Wang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ziyu Kuang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaotong Song
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xinyi Ma
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoyu Zhu
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ruike Gao
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Li
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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3
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Han KH, Choi YJ, Il Kim T, Park NH, Han KD, Lee DH. Association between glycemic status and the risk of gastric cancer in pre/peri-and postmenopausal women: A nationwide cohort study. Ann Epidemiol 2024; 94:106-112. [PMID: 38663524 DOI: 10.1016/j.annepidem.2024.04.009] [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: 08/01/2023] [Revised: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024]
Abstract
PURPOSE This study aimed to assess the correlation between glycemic status (prediabetes and type 2 diabetes mellitus) and the risk of gastric cancer according to menopausal status. METHODS A total of 982,559 pre/peri-menopausal and 1445,419 postmenopausal women aged ≥ 40, who underwent the Korean national health screening in 2009, were included and followed up until 2018. Hazard ratio (HR) and 95% confidence interval (CI) were calculated for development of gastric cancers according to hyperglycemic status in both groups using Cox proportional hazards models. RESULTS Over a mean follow-up period of 8.3 years, 3259 (0.33%) pre/peri-menopausal women and 13,245 (0.92%) postmenopausal women were diagnosed with gastric cancer. In postmenopausal women, only diabetes mellitus conferred a higher risk of gastric cancer compared to normal glycemic status (HR, 1.15; 95% CI, 1.09-1.20), with an increasing trend of gastric cancers from prediabetes to diabetes (P for trend < 0.001) observed regardless of menopausal status. Obesity, smoking, and heavy alcohol consumption was associated with increased gastric cancer risk mainly in the postmenopausal period. CONCLUSIONS The risk of gastric cancer escalates with deteriorating glycemic status in a dose-response manner. Diabetes mellitus is linked with an elevated risk of gastric cancer in postmenopausal women.
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Affiliation(s)
- Kyung Hee Han
- Gynecologic Cancer Center, Department of Obstetrics and Gynecology, CHA University Ilsan Medical Center, Goyang-si, Gyeonggi-do 10414, Republic of Korea
| | - Yoon Jin Choi
- Center for Gastric Cancer, National Cancer Center, Goyang-si, Gyeonggi-do 10408, Republic of Korea.
| | - Tae Il Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Noh Hyun Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Kyung-do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea.
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
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De la Torre K, Song M, Abe SK, Rahman MS, Islam MR, Saito E, Min S, Huang D, Chen Y, Gupta PC, Sawada N, Tamakoshi A, Shu X, Wen W, Sakata R, Kim J, Nagata C, Ito H, Park SK, Shin M, Pednekar MS, Tsugane S, Kimura T, Gao Y, Cai H, Wada K, Oze I, Shin A, Ahn Y, Ahsan H, Boffetta P, Chia KS, Matsuo K, Qiao Y, Rothman N, Zheng W, Inoue M, Kang D. Diabetes and gastric cancer incidence and mortality in the Asia Cohort Consortium: A pooled analysis of more than a half million participants. J Diabetes 2024; 16:e13561. [PMID: 38751364 PMCID: PMC11096812 DOI: 10.1111/1753-0407.13561] [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: 12/15/2023] [Revised: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Evidence suggests a possible link between diabetes and gastric cancer risk, but the findings remain inconclusive, with limited studies in the Asian population. We aimed to assess the impact of diabetes and diabetes duration on the development of gastric cancer overall, by anatomical and histological subtypes. METHODS A pooled analysis was conducted using 12 prospective studies included in the Asia Cohort Consortium. Among 558 981 participants (median age 52), after a median follow-up of 14.9 years and 10.5 years, 8556 incident primary gastric cancers and 8058 gastric cancer deaths occurred, respectively. Cox proportional hazard regression models were used to estimate study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) and pooled using random-effects meta-analyses. RESULTS Diabetes was associated with an increased incidence of overall gastric cancer (HR 1.15, 95% CI 1.06-1.25). The risk association did not differ significantly by sex (women vs men: HR 1.31, 95% CI 1.07-1.60 vs 1.12, 1.01-1.23), anatomical subsites (noncardia vs cardia: 1.14, 1.02-1.28 vs 1.17, 0.77-1.78) and histological subtypes (intestinal vs diffuse: 1.22, 1.02-1.46 vs 1.00, 0.62-1.61). Gastric cancer risk increased significantly during the first decade following diabetes diagnosis (HR 4.70, 95% CI 3.77-5.86), and decreased with time (nonlinear p < .01). Positive associations between diabetes and gastric cancer mortality were observed (HR 1.15, 95% CI 1.03-1.28) but attenuated after a 2-year time lag. CONCLUSION Diabetes was associated with an increased gastric cancer incidence regardless of sex, anatomical subsite, or subtypes of gastric cancer. The risk of gastric cancer was particularly high during the first decade following diabetes diagnosis.
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Grants
- R37 CA070867 NCI NIH HHS
- 30-A-15,23-A-31(toku),26-A-2,29-A-4 National Cancer Center Japan Research and Development Fund
- 24H1080 National Cancer Center Korea Research Grant
- 0520160-1 National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea
- 23-A-31 Ministry of Health, Labour and Welfare of Japan
- NRF-2016R1A2B4014552 National Research Foundation of Korea
- The Japanese Ministry of the Environment
- Ministry of Education, Culture, Sports, Science and Technology, Japan
- International Agency for Research on Cancer, Lyon, France
- 2210990 National Cancer Center Korea Research Grant
- US Department of Energy
- UM1 CA173640 NCI NIH HHS
- UM1 CA182910 NCI NIH HHS
- Ministry of Education, Culture, Sports, Science and Technology, Japan
- Ministry of Health, Labour and Welfare of Japan
- National Research Foundation of Korea
- Division of Cancer Prevention, National Cancer Institute
- The Japanese Ministry of the Environment
- International Agency for Research on Cancer, Lyon, France
- US Department of Energy
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Affiliation(s)
- Katherine De la Torre
- Department of Biomedical SciencesSeoul National University Graduate SchoolSeoulKorea
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Minkyo Song
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
- Laboratory of Epidemiology and Population SciencesNational Institute on Aging, National Institute of HealthBaltimoreMarylandUSA
| | - Sarah Krull Abe
- Division of PreventionNational Cancer Center Institute for Cancer ControlTokyoJapan
| | - Md. Shafiur Rahman
- Division of PreventionNational Cancer Center Institute for Cancer ControlTokyoJapan
- Research Center for Child Mental Development, Hamamatsu University School of MedicineTokyoJapan
| | - Md. Rashedul Islam
- Division of PreventionNational Cancer Center Institute for Cancer ControlTokyoJapan
- Hitotsubashi Institute for Advanced Study, Hitotsubashi UniversityTokyoJapan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and MedicineTokyoJapan
| | - Sukhong Min
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Dan Huang
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate SchoolSeoulKorea
| | - Yu Chen
- Department of Population Health and Environmental MedicineNYU Grossman School of MedicineNew YorkNew YorkUSA
| | | | - Norie Sawada
- Division of Cohort ResearchNational Cancer Center Institute for Cancer ControlTokyoJapan
| | - Akiko Tamakoshi
- Department of Public HealthHokkaido University Faculty of MedicineSapporoJapan
| | - Xiao‐Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Ritsu Sakata
- Radiation Effects Research FoundationHiroshimaJapan
| | - Jeongseon Kim
- Graduate School of Cancer Science and Policy, National Cancer CenterGoyangKorea
| | - Chisato Nagata
- Department of Epidemiology and Preventive MedicineGifu University Graduate School of MedicineGifuJapan
| | - Hidemi Ito
- Department of Preventive Medicine, Division of Cancer Information and ControlAichi Cancer Center Research InstituteNagoyaJapan
- Division of Descriptive Cancer EpidemiologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Sue K. Park
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Myung‐Hee Shin
- Department of Social and Preventive MedicineSungkyunkwan University School of MedicineSeoulKorea
| | | | - Shoichiro Tsugane
- Division of Cohort ResearchNational Cancer Center Institute for Cancer ControlTokyoJapan
- International University of Health and Welfare Graduate SchoolTokyoJapan
| | - Takashi Kimura
- Department of Public HealthHokkaido University Faculty of MedicineSapporoJapan
| | - Yu‐Tang Gao
- Department of EpidemiologyShanghai Cancer InstituteShanghaiChina
- Renji Hospital, Shanghai Jiaotong University School of MedicineShanghaiChina
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Keiko Wada
- Department of Epidemiology and Preventive MedicineGifu University Graduate School of MedicineGifuJapan
| | - Isao Oze
- Division of Cancer Epidemiology and PreventionAichi Cancer Center Research InstituteNagoyaJapan
| | - Aesun Shin
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
- Cancer Research Institute, Seoul National UniversitySeoulKorea
| | - Yoon‐Ok Ahn
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
| | - Habibul Ahsan
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook UniversityStony BrookNew YorkUSA
- Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of SingaporeSingaporeSingapore
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and PreventionAichi Cancer Center Research InstituteNagoyaJapan
- Department of Cancer EpidemiologyNagoya University Graduate School of Medicine NagoyaNagoyaJapan
| | - You‐Lin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMarylandUSA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Manami Inoue
- Division of PreventionNational Cancer Center Institute for Cancer ControlTokyoJapan
| | - Daehee Kang
- Department of Preventive MedicineSeoul National University College of MedicineSeoulKorea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate SchoolSeoulKorea
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Chen J, Ji Y, Liu Y, Cen Z, Chen Y, Zhang Y, Li X, Li X. Exhaled volatolomics profiling facilitates personalized screening for gastric cancer. Cancer Lett 2024; 590:216881. [PMID: 38614384 DOI: 10.1016/j.canlet.2024.216881] [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: 01/16/2024] [Revised: 04/02/2024] [Accepted: 04/09/2024] [Indexed: 04/15/2024]
Abstract
Gastric cancer (GC) is one of the most fatal cancers, characterized by non-specific early symptoms and difficulty in detection. However, there are no valid non-invasive screening tools available for GC. Here we establish a non-invasive method that employs exhaled volatolomics and ensemble learning to detect GC. We developed a comprehensive mass spectrometry-based procedure and determined of a wide range of volatolomics from 314 breath samples. The discovery, identification and verification research screened a biomarker panel to distinguish GC from controls. This panel has achieved 0.90 (0.87-0.94, 95%CI) accuracy, with an area under curve (AUC) of 0.92 (0.89-0.94, 95%CI) in discovery cohort and 0.88 (0.83-0.91, 95%CI) accuracy with an AUC of 0.91 (0.87-0.93, 95%CI) in replication cohort, which outperformed traditional serum markers. Single-cell sequencing and gene set enrichment analysis revealed that these exhaled markers originated from aldehyde oxidation and pyruvate metabolism. Our approach advances the design of exhaled analysis for GC detection and holds promise as a non-invasive method to the clinic.
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Affiliation(s)
- Jian Chen
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China
| | - Yongyan Ji
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China
| | - Yongqian Liu
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China
| | - Zhengnan Cen
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China
| | - Yuanwen Chen
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, PR China
| | - Yixuan Zhang
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, PR China
| | - Xiaowen Li
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, PR China.
| | - Xiang Li
- Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, PR China.
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Hardell KNL, Schonfeld SJ, Ramin C, Vo JB, Morton LM. Association between diabetes and subsequent malignancy risk among older breast cancer survivors. JNCI Cancer Spectr 2024; 8:pkae036. [PMID: 38718185 PMCID: PMC11135638 DOI: 10.1093/jncics/pkae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/28/2024] [Accepted: 05/03/2024] [Indexed: 05/30/2024] Open
Abstract
Type II diabetes is associated with cancer risk in the general population but has not been well studied as a risk factor for subsequent malignancies among cancer survivors. We investigated the association between diabetes and subsequent cancer risk among older (66-84 years), 1-year breast cancer survivors within the linked Surveillance Epidemiology and End Results (SEER)-Medicare database using Cox regression analyses to quantify hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). Among 133 324 women, 29.3% were diagnosed with diabetes before or concurrent with their breast cancer diagnosis, and 10 452 women developed subsequent malignancies over a median follow-up of 4.3 years. Diabetes was statistically significantly associated with liver (HR = 2.35, 95% CI = 1.48 to 3.74), brain (HR = 1.94, 95% CI = 1.26 to 2.96), and thyroid cancer risks (HR = 1.38, 95% CI = 1.01 to 1.89). Future studies are needed to better understand the spectrum of subsequent cancers associated with diabetes and the role of diabetes medications in modifying subsequent cancer risk, alone or in combination with cancer treatments.
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Affiliation(s)
- Kaitlyn N Lewis Hardell
- Radiation Epidemiology Branch, Division of Cancer Epidemiology, National Cancer Institute, Bethesda, MD, USA
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Sara J Schonfeld
- Radiation Epidemiology Branch, Division of Cancer Epidemiology, National Cancer Institute, Bethesda, MD, USA
| | - Cody Ramin
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jacqueline B Vo
- Radiation Epidemiology Branch, Division of Cancer Epidemiology, National Cancer Institute, Bethesda, MD, USA
| | - Lindsay M Morton
- Radiation Epidemiology Branch, Division of Cancer Epidemiology, National Cancer Institute, Bethesda, MD, USA
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7
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Yau STY, Leung E, Wong MCS, Hung CT, Chong KC, Lee A, Yeoh EK. Metabolic dysfunction-associated profiles and subsequent site-specific risk of obesity-related cancers among Chinese patients with diabetes: a retrospective cohort study. BMJ Open 2024; 14:e082414. [PMID: 38569684 PMCID: PMC11146369 DOI: 10.1136/bmjopen-2023-082414] [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: 11/22/2023] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVES To compare metabolic dysfunction-associated profiles between patients with diabetes who developed different obesity-related site-specific cancers and those who remained free of cancer during follow-up. DESIGN Retrospective cohort study. SETTING Public general outpatient clinics in Hong Kong. PARTICIPANTS Patients with diabetes without a history of malignancy (n=391 921). PRIMARY OUTCOME MEASURES The outcomes of interest were diagnosis of site-specific cancers (colon and rectum, liver, pancreas, bladder, kidney and stomach) during follow-up. Cox proportional hazards regression was applied to assess the associations between metabolic dysfunction and other clinical factors with each site-specific cancer. RESULTS Each 0.1 increase in waist-to-hip ratio was associated with an 11%-35% elevated risk of colorectal, bladder and liver cancers. Each 1% increase in glycated haemoglobin was linked to a 4%-9% higher risk of liver and pancreatic cancers. While low-density lipoprotein cholesterol and triglycerides were inversely associated with the risk of liver and pancreatic cancers, high-density lipoprotein cholesterol was negatively associated with pancreatic, gastric and kidney cancers, but positively associated with liver cancer. Furthermore, liver cirrhosis was linked to a 56% increased risk of pancreatic cancer. No significant association between hypertension and cancer risk was found. CONCLUSIONS Metabolic dysfunction-associated profiles contribute to different obesity-related cancer outcomes differentially among patients with diabetes. This study may provide evidence to help identify cancer prevention targets during routine diabetes care.
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Affiliation(s)
- Sarah Tsz Yui Yau
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Eman Leung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Martin Chi Sang Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Tim Hung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Chun Chong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Albert Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng Kiong Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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8
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Wang L, Zhang Z. Diabetes Mellitus and Gastric Cancer: Correlation and Potential Mechanisms. J Diabetes Res 2023; 2023:4388437. [PMID: 38020199 PMCID: PMC10653978 DOI: 10.1155/2023/4388437] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 10/22/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
This review summarizes the correlation between diabetes mellitus (DM) and gastric cancer (GC) from the perspectives of epidemiology, drug use, and potential mechanisms. The association between DM and GC is inconclusive, and the positive direction of the association reported in most published meta-analyses suggests that DM may be an independent risk factor for GC. Many clinical investigations have shown that people with DM and GC who undergo gastrectomy may have better glycemic control. The potential link between DM and GC may involve the interaction of multiple common risk factors, such as obesity, hyperglycemia and hyperinsulinemia, H. pylori infection, and the use of metformin. Although in vitro and in vivo data support that H. pylori infection status and metformin can influence GC risk in DM patients, there are conflicting results. Patient survival outcomes are influenced by multiple factors, so further research is needed to identify the patients who may benefit.
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Affiliation(s)
- Li Wang
- Department of Emergency, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China
- Zhejiang Provincial Critical Research Center for Emergency Medicine Clinic, Hangzhou 310052, China
- Key Laboratory of Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou 310052, China
| | - Zhe Zhang
- Department of Emergency Medicine, The First People's Hospital of Linping District, 311100, Hangzhou, Zhejiang, China
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Corso G, Tagliaferri V, Massari G, Cioffi A, Rossi EMC, Veronesi P, Magnoni F. CDH1 mutations recurrence and global clustering in genetically tested families with hereditary diffuse gastric cancer syndrome: results from a systematic study. Fam Cancer 2023; 22:187-192. [PMID: 35882702 DOI: 10.1007/s10689-022-00309-w] [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: 02/25/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
The global distribution of germline CDH1 mutations in hereditary diffuse gastric cancer families, is highly heterogenous. The aim of this study was to determine if there is any geographic clustering of CDH1 mutations in families with the hereditary diffuse gastric cancer syndrome. Data from 1998 to 2021 were collected systematically according to the PRISMA guidelines. 571 germline CDH1 mutations were recorded worldwide, with 387 (67.8%) of them reported in 108 families. The largest clusters of CDH1 mutations were identified in central Europe, north America, northern Europe, New Zealand (Māori), and south America. A high penetrance risk for GC development was observed for c.1008G > T in New Zealand (Māori), c.1565 + 2insT in northern Europe, c.1901C > T in Portugal, and c.1003C > T in the USA. Our observations are consistent with a specific local clustering of some recurrent CDH1 mutations within specific countries.
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Affiliation(s)
- Giovanni Corso
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy.
- Department of Oncology and Hemato-Oncology, Faculty of Medicine, University of Milan, Milan, Italy.
| | | | - Giulia Massari
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Antonio Cioffi
- Division of Urology, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Paolo Veronesi
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, Faculty of Medicine, University of Milan, Milan, Italy
| | - Francesca Magnoni
- Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
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10
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Thrift AP, Wenker TN, El-Serag HB. Global burden of gastric cancer: epidemiological trends, risk factors, screening and prevention. Nat Rev Clin Oncol 2023; 20:338-349. [PMID: 36959359 DOI: 10.1038/s41571-023-00747-0] [Citation(s) in RCA: 108] [Impact Index Per Article: 108.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 03/25/2023]
Abstract
Gastric cancer remains a major cause of cancer-related mortality worldwide. The temporal trends for this malignancy, however, are dynamic, and reports from the past decade indicate important declines in some regions and demographic groups, as well as a few notable exceptions in which gastric cancer rates are either stable or increasing. Two main anatomical subtypes of gastric cancer exist, non-cardia and cardia, with different temporal trends and risk factors (such as obesity and reflux for cardia gastric cancer and Helicobacter pylori infection for non-cardia gastric cancer). Shifts in the distribution of anatomical locations have been detected in several high-incidence regions. H. pylori is an important aetiological factor for gastric cancer; importantly, the anticipated long-term findings from studies examining the effect of H. pylori eradication on the risk of (re)developing gastric cancer have emerged in the past few years. In this Review, we highlight the latest trends in incidence and mortality using an evidence-based approach. We make the best possible inferences, including clinical and public health inference, on the basis of the quality of the evidence available, and highlight burning questions as well as gaps in knowledge and public health practice that need to be addressed to reduce gastric cancer burden worldwide.
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Affiliation(s)
- Aaron P Thrift
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Theresa Nguyen Wenker
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Hashem B El-Serag
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
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11
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Mathebela P, Damane BP, Mulaudzi TV, Mkhize-Khwitshana ZL, Gaudji GR, Dlamini Z. Influence of the Microbiome Metagenomics and Epigenomics on Gastric Cancer. Int J Mol Sci 2022; 23:13750. [PMID: 36430229 PMCID: PMC9693604 DOI: 10.3390/ijms232213750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022] Open
Abstract
Gastric cancer (GC) is one of the major causes of cancer deaths worldwide. The disease is seldomly detected early and this limits treatment options. Because of its heterogeneous and complex nature, the disease remains poorly understood. The literature supports the contribution of the gut microbiome in the carcinogenesis and chemoresistance of GC. Drug resistance is the major challenge in GC therapy, occurring as a result of rewired metabolism. Metabolic rewiring stems from recurring genetic and epigenetic factors affecting cell development. The gut microbiome consists of pathogens such as H. pylori, which can foster both epigenetic alterations and mutagenesis on the host genome. Most of the bacteria implicated in GC development are Gram-negative, which makes it challenging to eradicate the disease. Gram-negative bacterium co-infections with viruses such as EBV are known as risk factors for GC. In this review, we discuss the role of microbiome-induced GC carcinogenesis. The disease risk factors associated with the presence of microorganisms and microbial dysbiosis are also discussed. In doing so, we aim to emphasize the critical role of the microbiome on cancer pathological phenotypes, and how microbiomics could serve as a potential breakthrough in determining effective GC therapeutic targets. Additionally, consideration of microbial dysbiosis in the GC classification system might aid in diagnosis and treatment decision-making, taking the specific pathogen/s involved into account.
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Affiliation(s)
- Precious Mathebela
- Department of Surgery, Steve Biko Academic Hospital, University of Pretoria, Hatfield 0028, South Africa
| | - Botle Precious Damane
- Department of Surgery, Steve Biko Academic Hospital, University of Pretoria, Hatfield 0028, South Africa
| | - Thanyani Victor Mulaudzi
- Department of Surgery, Steve Biko Academic Hospital, University of Pretoria, Hatfield 0028, South Africa
| | - Zilungile Lynette Mkhize-Khwitshana
- School of Medicine, University of Kwa-Zulu Natal, Durban, KwaZulu-Natal 4013, South Africa
- SAMRC Research Capacity Development Division, South African Medical Research Council, Tygerberg, Cape Town 7501, South Africa
| | - Guy Roger Gaudji
- Department of Urology, Level 7, Bridge C, Steve Biko Academic Hospital, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa
| | - Zodwa Dlamini
- SAMRC Precision Oncology Research Unit (PORU), DSI/NRF SARChI Chair in Precision Oncology and Cancer Prevention (POCP), Pan African Cancer Research Institute (PACRI), University of Pretoria, Hatfield 0028, South Africa
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12
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Yin L, Zhang W, Liu L, Guo L, Guo M, He X, Zhu L. Application of nursing intervention based on the IKAP model in self-management of patients with gastric cancer. Am J Transl Res 2022; 14:6389-6398. [PMID: 36247277 PMCID: PMC9556496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 07/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND To explore the effect of IKAP nursing intervention on the self-management of patients with gastric cancer, so as to improve the patient's disease management ability and healthy behaviors. METHODS In this retrospective study, a total of 124 patients with gastric cancer were included. The experimental group received the self-management intervention program for gastric cancer patients based on the IKAP model, and the control group only received routine nursing. The psychological status, quality of life, cancer-related symptoms, and self-management ability of the two groups were observed; moreover, multiple regression analysis was used to identify the risk factors of self-management. RESULTS The nursing intervention based on the IKAP model had obvious effects on patients with gastric cancer. The SUPPH score was improved significantly after nursing intervention in the experimental group, and the improvement was more significant as compared to control group (both P < 0.05). The quality of life was significantly improved in the experimental group as compared with control group. The incidence of partial cancer-related symptoms, such as infection, fatigue and recurrent peptic ulcer in the experimental group was significantly lower after nursing intervention as compared with control group (all P < 0.05). Moreover, the regression analysis showed that being single, divorced or separated, widowed, as well as self-management nursing intervention, and quality of life showed significant correlation with self-management behavior. The multiple regression analysis demonstrated that psychological function (p = 0.003) and self-management nursing intervention (p < 0.0001) were the independent risk factors. CONCLUSIONS Nursing intervention based on the IKAP model for patients with gastric cancer plays a positive role in improving the self-management ability of gastric cancer patients and improving their negative emotions.
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Affiliation(s)
- Ling Yin
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Gannan Medical CollegeGanzhou 341000, Jiangxi, China
| | - Wenhong Zhang
- Department of Five Subjects of General Surgery, The First Affiliated Hospital of Gannan Medical CollegeGanzhou 341000, Jiangxi, China
| | - Lianhua Liu
- Department of Medical Oncology, The First Affiliated Hospital of Gannan Medical CollegeGanzhou 341000, Jiangxi, China
| | - Lihua Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Gannan Medical CollegeGanzhou 341000, Jiangxi, China
| | - Meihua Guo
- Department of Medical Oncology, The First Affiliated Hospital of Gannan Medical CollegeGanzhou 341000, Jiangxi, China
| | - Xiao He
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Gannan Medical CollegeGanzhou 341000, Jiangxi, China
| | - Lixia Zhu
- Department of Medical Oncology, The First Affiliated Hospital of Gannan Medical CollegeGanzhou 341000, Jiangxi, China
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13
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Tiengo T, Fernandes GA, Curado MP. Gastric adenocarcinoma: 1-year overall survival, disability-adjusted life years, years of life lost, and prognostic factors—a single-institution experience. Front Oncol 2022; 12:918833. [PMID: 36158672 PMCID: PMC9493081 DOI: 10.3389/fonc.2022.918833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/26/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To analyze factors affecting 1-year overall survival and burden of gastric adenocarcinoma in a single-institution cohort. Methods A prospective cohort study of gastric adenocarcinoma patients from a cancer center in São Paulo, Brazil, was conducted between February 2016 and July 2019. Overall survival was analyzed at 12 months post-diagnosis using the Kaplan–Meier method. A log-rank test was applied to compare curves. Sociodemographic and clinicopathological features were assessed to detect prognostic factors using univariate and multivariable Cox regression analyses to calculate hazard ratio (HR) and its confidence intervals (CIs). Disability-adjusted life years (DALY) constituted the sum of years of life lost (YLL) plus years lived with disability (YLD). YLL represented the sum of years lost before the age of 76.6 years. YLD was calculated as the number of cases multiplied by the duration and burden of the disease. YLL per death was calculated as the mean YLL for each individual. Results Overall survival at 1-year follow-up was 80.8%. The multivariable model adjusted for age and sex identified cerebrovascular disease (HR 8.5, 95% CI 3.3–21.8), stage III/IV (HR 5.7, 95% CI 2.3–13.7), diabetes (HR 3.2, 95% CI 1.5–6.6), and<9 years of education (HR 2.9, 95% CI 1.5–5.8) as prognostic factors. Out of the 214 treated cases, there was 700.72 DALY during the first year, of which 90.55% corresponded to YLL and 9.45% to YLD. The average YLL per death was 15.48 and was higher among women (19.24 YLL per death). Conclusion At a single cancer center, 1-year overall survival probability was approximately 80% in patients with gastric adenocarcinoma. Patients with a higher risk of death had cerebrovascular disease, advanced clinical staging, diabetes, and/or lower educational level. Approximately 700 years of DALY was documented, with women having the highest YLL per death. Because this study was conducted at a single cancer center, the results might not be representative of a general population. To the best of our knowledge, this study was the first to assess gastric adenocarcinoma DALY, YLL, and YLL per death in the first year of follow-up in a hospital cohort in Brazil.
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Affiliation(s)
- Tatiane Tiengo
- Post Graduation Program A.C. Camargo Cancer Center, São Paulo, Brazil
- *Correspondence: Maria Paula Curado, ; Tatiane Tiengo,
| | | | - Maria Paula Curado
- Nucleus of Epidemiology and Statistics in Cancer, A. C. Camargo Cancer Center, São Paulo, Brazil
- *Correspondence: Maria Paula Curado, ; Tatiane Tiengo,
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