Sleep Duration and Stress Level in the Risk of Gastric Cancer: A Pooled Analysis of Case-Control Studies in the Stomach Cancer Pooling (StoP) Project

Habitual sleep duration, healthy eating, and digestive system cancer mortality

BACKGROUND

Lifestyle choices, such as dietary patterns and sleep duration, significantly impact the health of the digestive system and may influence the risk of mortality from digestive system cancer.

METHODS

This study aimed to examine the associations between sleep duration, dietary habits, and mortality from digestive system cancers. The analysis included 406,584 participants from the UK Biobank cohort (54.1% women; age range: 38-73 years), with sleep duration classified as short (≤ 6 h, 24.2%), normal (7-8 h, 68.4%), and long (≥ 9 h, 7.4%). Healthy eating habits were defined as a daily intake of at least 25 g of fibre, seven portions of fruits and vegetables, and fewer than four servings of meat per week. These dietary factors were combined into a score ranging from 0 (least healthy) to 3 (healthiest). Cox proportional hazards regression analyses were conducted, with a median follow-up period of 12.6 years, ending on September 30, 2021.

RESULTS

3949 participants died from cancer of the digestive system. Both short and long sleep duration were associated with an increased risk of mortality from cancer of the digestive system (1.09 (1.01-1.18) and 1.14 (1.03-1.27), respectively). Additionally, a diet score ≥ 1 was linked to a lower cancer risk (0.72-0.91 (0.59-0.96)). Adjusting for smoking, type 2 diabetes, and body mass index (BMI) status eliminated the association between sleep duration and digestive cancer mortality. The association between healthy dietary patterns and the risk of digestive system cancer mortality did not vary by sleep duration.

CONCLUSIONS

Aberrant sleep durations may increase the risk of mortality from digestive system cancer, potentially through smoking, higher BMI, and type 2 diabetes. However, aberrant sleep durations do not seem to reduce the protective effects of a healthy dietary pattern.

Circadian rhythm genes contribute to the prognosis prediction and potential therapeutic target in gastric cancer

The role of circadian rhythm genes (CRGs) in gastric cancer (GC) is poorly understood. This study aimed to develop a CRG signature to improve understanding of prognosis and immunotherapy responses in GC patients. We integrated the The Cancer Genome Atlas-Stomach adenocarcinoma (TCGA-STAD) dataset with CRGs to develop a prognostic signature for GC. The signature's predictive ability was validated using Kaplan-Meier and ROC curves. The CIBERSORT algorithm evaluated immune cell proportions, and tumor immune dysfunction and exclusion score, as well as immune phenotype score, determined the response to immunotherapy for STAD patients. Finally, we assessed signature genes expression using real-time quantitative polymerase chain reaction. We developed a 4-CRG signature for STAD, demonstrating accurate prognostic ability. The low-risk group showed increased B cell memory and CD8 + T cells, and decreased M2 Macrophages compared to the high-risk group. Patients in the low-risk group had a higher likelihood of benefiting from immunotherapy. Additionally, gastric cancer tissues exhibited elevated expression of OPN3 and decreased expression of TP53 compared to adjacent tissue. This study successfully established a prognostic signature for CRGs, accurately predicting prognosis and immunotherapeutic response among STAD patients, providing insights for the development of personalized therapeutic strategies for these patients.

The global gastric cancer consortium: an update from the Stomach cancer Pooling (StoP) project

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.

Impact of sleep on gastrointestinal cancer

Sleep problems have become a significant public health concern, affecting a large portion of the global population and have been linked to increased morbidity and mortality. The incidence of gastrointestinal (GI) cancers continues to rise, posing a substantial burden on healthcare systems worldwide. This editorial aims to delve into the impact of sleep on GI cancers, including esophageal, gastric, colorectal, hepatobiliary, and pancreatic cancer. Recent literature investigating the potential connections between GI cancers and sleep was reviewed. We considered aspects such as sleep duration, sleep disorders, and circadian rhythmicity, in order to explore the underlying mechanisms that can contribute to the development of GI cancers and propose avenues for future research.

Clean energy consumption, sleep duration, and the association of cancer: findings from the China health and retirement longitudinal study

Objective

Studies of the association between clean energy consumption, sleep duration, and cancer are still extremely limited. We aim to investigate the individual or joint role of clean energy consumption, and sleep duration in cancer onset.

Methods

We used data from the China Health and Retirement Longitudinal Study. Multivariable locally weighted regression (LOESS) models were first used to assess the individual association of daily sleep time with the risk to develop cancer. Multivariate logistic regression models were conducted on the individual and interaction effects of daily sleep time and cooking fuel.

Results

We found that short sleep duration (≤6 hours) and non-clean energy consumption were respectively associated with an increased risk of cancer among older Chinese(p<0.05). We assessed daily sleep time in four quartiles, the adjusted odds ratios (AOR), and 95% confidence intervals (95% CI) for participants in the second (5.0 to <6.5 hours), third (6.5 to <8.0 hours), and fourth quartiles (≥8.0 hours) were 0.88 (95% CI: 0.65-1.20), 0.61 (95% CI: 0.40-0.91), and 0.53 (95% CI: 0.37-0.77), respectively. When we set the cutoff point(6.5 hours), participants who slept more than 6 hours had a 39% lower risk of cancer (AOR: 0.61, 95% CI: 0.46-0.79) compared with others. On the other hand, we conducted that exposure to clean fuel from cooking was negatively associated with cancer incidence (AOR: 0.73, 95% CI: 0.54, 0.97). Furthermore, the combination of longer sleep and cleaner fuels showed the lowest OR for cancer (AOR: 0.39, 95% CI: 0.24, 0.65).

Conclusion

Our study showed that sleep duration and clean energy consumption were significantly associated with cancer in elderly Chinese people. In addition, the prevalence of cancer was higher among people who slept less than six hours and used non-clean energy sources. Paying greater attention to the effects of sleep duration and clean energy on the risk of cancer may yield practical implications for cancer prevention.