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1
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Marino M, Martini D, Venturi S, Tucci M, Porrini M, Riso P, Del Bo' C. An Overview of Registered Clinical Trials on Glucosinolates and Human Health: The Current Situation. Front Nutr 2021; 8:730906. [PMID: 34778334 PMCID: PMC8578719 DOI: 10.3389/fnut.2021.730906] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/24/2021] [Indexed: 12/15/2022] Open
Abstract
Epidemiological studies suggest a potential role of glucosinolates (GSLs) and isothiocyanates on human health. However, evidence from intervention studies, due to heterogeneity in features of study design, duration, participants, food or food components administered, and outcomes analyzed, is still insufficient. The current review aims to provide an overview of the trials on GSLs and GSL-rich foods registered over the last 20 years with the intention to summarize the main topics and results, but also the existing gaps that still need to be covered. Studies were collected by using ClinicalTrials.gov and the International Standard Randomized Controlled Trial Number (ISRCTN) registry. A total of 87 registered trials were identified with which most of them were performed by using extracts or pure compounds (n = 60) while few were conducted with GSL-rich foods (n = 27). In detail, sulforaphane was the most investigated compound, while broccoli was the most frequent food tested in the trials. The majority of the studies assessed the health effects of GSLs focusing on outcomes related to cancer and cognitive function, even if the current findings are not univocal. Emerging topics also included the study of GSLs and gut microbiota interaction and impact on skin health. Further attention was also drawn to the bioavailability of GSLs and/or derivatives from foods, extracts, and single compounds by also considering the contribution of the different genetic polymorphisms. In conclusion, although considerable efforts have been made to study GSLs and GSL-rich foods, further studies are necessary to provide evidence-based research and to corroborate the findings obtained. The interindividual response due to genetic polymorphisms should be further investigated in order to explore the contribution to the overall beneficial effect.
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Affiliation(s)
| | | | | | | | | | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, Milan, Italy
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2
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Tong Y, Wang H, Zhao Y, He X, Xu H, Li H, Shuai P, Gong L, Wu H, Xu H, Luo Y, Wang D, Liu S, Song Z. Diagnostic Value of Serum Pepsinogen Levels for Screening Gastric Cancer and Atrophic Gastritis in Asymptomatic Individuals: A Cross-Sectional Study. Front Oncol 2021; 11:652574. [PMID: 34504781 PMCID: PMC8421685 DOI: 10.3389/fonc.2021.652574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/22/2021] [Indexed: 01/04/2023] Open
Abstract
Background Pepsinogens (PGs) can be used for gastric cancer (GC) screening, but the cutoff levels vary among studies, and PG levels are influenced by numerous factors. The aim of this article is to examine the diagnostic value of PG levels and Helicobacter pylori (Hp) status for GC and atrophic gastritis screening in asymptomatic individuals undergoing health checkup in China. Patients and Methods This was a multicenter cross-sectional study of subjects who underwent health checkup from 10/2016 to 10/2018 at nine International Healthcare Centers in China. All participants underwent gastroscopy and pathological examination, serum PG, 13C-urea breath test, and/or Hp serological current infection marker rapid test, all on the same day. PG-related parameters were analyzed in different Hp subgroups and regions. Results The patients were grouped as non-atrophic (NAG, n = 1,590), mild to moderate atrophic (MAG, n = 273), severe atrophic (SAG, n = 49), and GC (n = 10). The serum PG levels in these groups decreased with increasing pathological severity. In the same pathological groups, PGI and PGII levels were higher in the Hp-positive subgroup, while PGR (PGI/PGII ratio) was lower (P < 0.05). The best cutoff values for atrophy diagnosis were PGI ≤73.1 ng/ml and PGR ≤9.8, for severe atrophy were PGI ≤63.9 ng/ml and PGR ≤9.09, and for GC was PGR ≤4.7 (all P < 0.05 and area under the curve >0.7). The cutoff points varied with Hp status and China regions. Conclusion Serum PG levels might be used for the screening of gastric atrophic gastritis lesions. The results suggest that different cutoff values should possibly be used in different Hp status groups and geographical regions, but it will have to be validated in future studies. Future studies should also examine the value of PG levels for GC detection.
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Affiliation(s)
- Yuling Tong
- Department of General Practice/Health Management Center, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Hongguang Wang
- Department of Gastroenterology, Jilin City People's Hospital, Jilin, China
| | - Yi Zhao
- Department of General Practice/Health Management Center, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Xueqiang He
- Department of Gastroenterology, No. 924 Hospital of the People's Liberation Army of China, Guilin, China
| | - Hongwei Xu
- Department of Gastroenterology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China
| | - Hong Li
- Department of Health Medicine, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Ping Shuai
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Lirong Gong
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hongbo Wu
- Department of Gastroenterology, The First Hospital Affiliated to AMU (Southwest Hospital), Chongqing, China
| | - Hongzhi Xu
- Department of Gastroenterology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Yinhu Luo
- Department of Gastroenterology, Jingzhou Hospital of Traditional Chinese Medicine, Jingzhou, China
| | - Dong Wang
- Department of Gastroenterology, Shanghai Changhai Hospital, Shanghai, China
| | - Shizhu Liu
- Department of Gastroenterology, Jilin City People's Hospital, Jilin, China
| | - Zhenya Song
- Department of General Practice/Health Management Center, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
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3
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Barekzai AM, Aminianfar A, Mousavi SM, Esmaillzadeh A. The Association between Dietary Inflammatory Potential and Gastric Cancer: A Case Control Study. Nutr Cancer 2021; 74:463-471. [PMID: 33560151 DOI: 10.1080/01635581.2021.1883682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
OBJECTIVE No report is available about diet-disease associations in the understudied region of Afghanistan. Although the inflammatory potential of diet has been linked with several cancers, information about gastric cancer is scarce. The present study aimed to investigate the relationship between the inflammatory potential of the diet and odds of gastric cancer in Afghanistan. METHODS In this hospital-based case-control study, we enrolled 90 newly-diagnosed cases of gastric cancer and 180 age (±5) and sex-matched controls. All cases were pathologically confirmed gastric cancer patients, with no history of any type of other pathologically confirmed cancers. Controls were healthy individuals and relatives of patients in the hospital. Dietary assessment was done by a pre-tested food frequency questionnaire. DII was calculated based on energy-adjusted amounts of several foods and nutrients with inflammatory or anti-inflammatory potential, as introduced by earlier studies. RESULTS Mean age of study participants was 54 years, of them 73% were males. After adjustment for age and sex, individuals in the highest tertile of the inflammatory potential of the diet were 2.47 times (95% CI: 1.31-4.66) more likely to have gastric cancer compared with those in the lowest tertile. Further adjustment for other potential confounders did not substantially affect the association; such that participants with the greatest inflammatory potential of the diet had approximately 3.59 times (95% CI: 1.16-11.02) increased odds of gastric cancer than those with the lowest adherence. Additional adjustment for BMI strengthened the association (OR: 3.75; 95% CI: 1.14-12.30). CONCLUSION We found a significant positive association between inflammatory potential of the diet and risk of gastric cancer. Further studies with prospective nature are required to confirm this association.
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Affiliation(s)
- Ahmad Mujtaba Barekzai
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Aminianfar
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Science, Kashan, Iran
| | - Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Pes GM, Fanciulli G, Delitala AP, Piana AF, Dore MP. Spatial Association between Gastric Cancer Mortality and Goiter in Sardinia. Asian Pac J Cancer Prev 2021; 22:105-110. [PMID: 33507686 PMCID: PMC8184186 DOI: 10.31557/apjcp.2021.22.1.105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Gastric cancer (GC) is the third leading cause of cancer mortality worldwide. The incidence of GC varies between countries according to exposure to different risk factors. Hypothyroidism has been suggested as a potential GC risk factor. In Sardinia, Italy, the prevalence of endemic goiter is high and GC mortality is unevenly distributed. This ecological study aimed to investigate GC mortality and its relationship with hypothyroidism, adjusting for potential confounders. Methods: The spatial association between GC mortality and goiter (a proxy of hypothyroidism), diet, stature and pastoralism (a proxy of Helicobacter pylori infection), available at the aggregated level, was modelled in the island’s 377 municipalities, separately by sex, using geographically weighted regression (GWR). Results: The GC standardized mortality ratio ranged from 0.0 to 10.4 across municipalities. A hotspot of GC mortality was detected in the central mountainous area of Sardinia among males, positively associated with goiter (GWR estimate 0.213 ± 0.122), and the practice of sheep‒rearing (GWR estimate 0.127 ± 0.080), whereas a negative association with the diet score (GWR estimate 0.032 ± 0.034), and null for stature were found. No significant associations were found in females. Conclusion: Within the limitations of ecological studies goiter prevalence was an independent predictor of GC mortality in males.
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Affiliation(s)
- Giovanni Mario Pes
- Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, University of Sassari, Sassari 07100, Italy
| | - Giuseppe Fanciulli
- Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, University of Sassari, Sassari 07100, Italy
| | | | - Andrea Fausto Piana
- Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, University of Sassari, Sassari 07100, Italy
| | - Maria Pina Dore
- Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, University of Sassari, Sassari 07100, Italy.,Baylor College of Medicine, 77030 Houston, Texas, USA
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5
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Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients 2020; 12:nu12123756. [PMID: 33297391 PMCID: PMC7762239 DOI: 10.3390/nu12123756] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/21/2022] Open
Abstract
PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched for meta-analyses that provided risk estimates (±95% confidence intervals) for associations between intakes of whole and refined grains and risk of total and site-specific cancer. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Only meta-analyses that included whole grains and refined grains as separate food groups, and not as part of dietary patterns, were included. A total of 17 publications were identified that met inclusion criteria. Within these, results from a total of 54 distinct meta-analyses were reported for whole grains and 5 meta-analyses for refined grains. For total cancer mortality, 7 meta-analyses of cohort studies indicated that whole grain intake was associated with 6% to 12% lower risk in comparison of highest vs. lowest intake groups, and 3% to 20% lower risk for doses ranging from 15 to 90 g/day. For site-specific cancers, meta-analyses indicated that whole grain intake was consistently associated with lower risks of colorectal, colon, gastric, pancreatic, and esophageal cancers. Limited data were available for refined grains, with only 4 publications providing risk estimates, and only 1 of the meta-analyses included more than 3 studies. High intake of refined grains was associated with increased risk of colon and gastric cancer. By contrast, in the only dose-response meta-analysis, each 90 g/day consumption of refined grains was associated with a 6% lower risk of total cancer. In addition to the limited number of published meta-analyses on refined grains, results were also weakened due to the fact that refined grains were frequently defined to include both staple grain foods and indulgent grain foods, and the majority of studies included in the meta-analyses provided no specific definition of refined grains. Overall, meta-analyses of cohort and case-control studies consistently demonstrate that whole grain intake is associated with lower risk of total and site-specific cancer, and support current dietary recommendations to increase whole grain consumption. By contrast, the relationship between refined grain intake and cancer risk is inconclusive.
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6
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Wang T, Zhan R, Lu J, Zhong L, Peng X, Wang M, Tang S. Grain consumption and risk of gastric cancer: a meta-analysis. Int J Food Sci Nutr 2019; 71:164-175. [PMID: 31314629 DOI: 10.1080/09637486.2019.1631264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study evaluated the relationship between grain consumption and the risk of gastric cancer. A total of 19 studies met the inclusion criteria. For whole grain consumption, there was a 13% reduction in the risk of gastric cancer (p = .003), and a subgroup analysis showed that a large amount of whole grain consumption reduced the risk of gastric cancer by 44% (p < .001). For refined grain consumption, there was a 36% increase in the risk of gastric cancer (p < .001); a subgroup analysis showed that a large and a moderate amount of refined grain consumption increased the risk of gastric cancer by 63% (p < .001) and 28% (p < .001), respectively. A large intake of whole grains might be protective against gastric cancer, whereas the ingestion of refined cereals may be a risk factor for gastric cancer. Moreover, the risk of cancer increases with the increase of refined grain intake.
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Affiliation(s)
- Tonghua Wang
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China.,Department of Gastroenterology, Affiliated Hospital of Youjiang Medical University for Nationlities, Baise, China
| | - Rui Zhan
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China.,Department of Gastroenterology, Xiangyang Central Hospital, XiangYang, China
| | - Jiao Lu
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Lu Zhong
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - XiaoJuan Peng
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China.,Department of Endocrinology, Affiliated Hospital of Xiangnan University, Chenzhou, China
| | - Min Wang
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Shaohui Tang
- Department of Gastroenterology, The First Affiliated Hospital, Jinan University, Guangzhou, China
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7
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Morrison MEW, Joseph JM, McCann SE, Tang L, Almohanna HM, Moysich KB. Cruciferous Vegetable Consumption and Stomach Cancer: A Case-Control Study. Nutr Cancer 2019; 72:52-61. [PMID: 31094219 DOI: 10.1080/01635581.2019.1615100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective: To investigate the association between regular cruciferous vegetable intake and stomach cancer.Methods: A hospital-based, case-control study was conducted at Roswell Park Comprehensive Cancer Center in Buffalo, NY, which included 292 stomach cancer patients and 1168 cancer-free controls recruited between 1992 and 1998 as part of the Patient Epidemiology Data System (PEDS). Dietary and other epidemiologic and confounding variables were collected by questionnaire. Multivariable logistic regression analyses were utilized to estimate odds ratios (OR) and 95% confidence intervals (CI) for associations between usual pre-diagnostic cruciferous vegetable intake and stomach cancer, with adjustment for other stomach cancer risk factors and dietary characteristics.Results: We observed strong inverse associations between stomach cancer and highest versus lowest intakes of total cruciferous vegetables (OR = 0.59, 95% CI: 0.42-0.83), raw cruciferous vegetables (OR = 0.53, 95% CI: 0.38-0.73), raw broccoli (OR = 0.61, 95% CI: 0.43-0.86), raw cauliflower (OR = 0.51, 95% CI: 0.35-0.73), and Brussels sprouts (OR = 0.66, 95% CI = 0.48-0.91).Conclusions: These data suggest that consuming raw cruciferous vegetables may be associated with a lower odds of stomach cancer, even after considering other dietary characteristics.
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Affiliation(s)
- Maia E W Morrison
- Science Research Program, University at Buffalo, Buffalo, New York, USA
| | - Janine M Joseph
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Susan E McCann
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Hani M Almohanna
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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8
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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: 25] [Impact Index Per Article: 4.2] [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).
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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
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9
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Levi F, La Vecchia C, Te VC. Descriptive Epidemiology of Adenocarcinomas of the Cardia and Distal Stomach in the Swiss Canton of Vaud. TUMORI JOURNAL 2018; 76:167-71. [PMID: 2330608 DOI: 10.1177/030089169007600203] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Incidence registration and survival data from various anatomical subsites of gastric cancer have been abstracted from the population-based Cancer Registry of the Swiss Canton of Vaud for the period 1976-87. Overall age-standardized (Vaud population in 1980) incidence rates for all gastric adenocarcinomas were 22.2/100,000 males and 8.3/100,000 females, with a sex ratio of 2.7. The male preponderance was appreciably greater for cardia (5.9 vs 0.9, sex ratio = 6.5) than for distal stomach (10.2 vs 5.0, sex ratio = 2.0). Adenocarcinomas of unspecified origin had an intermediate sex ratio (2.6). The sex ratio for all gastric adenocarcinomas was lower in the third and fourth decades of age (1.3) than at older ages. In relation to calendar period of diagnosis, no appreciable trend with time was observed for adenocarcinomas of the cardia, and only some modest decline was observed for distal stomach, in the presence of stable sex ratios. A marked fall was observed for « other and unspecified » subsites. Thus, the overall decline in the incidence of gastric adenocarcinomas over the calendar period considered was about 20% for males and 30% for females. Five-year survival was significantly higher for cancers arising in the distal stomach (30%) than for cardiac carcinomas (11%), and intermediate for « other and unspecified sites » (19%). These results indicate that adenocarcinomas arising from the cardia and those arising from the distal stomach are considerably heterogeneous in relation to descriptive epidemiology and prognosis. This may have relevant etiological correlates, particularly since carcinoma of the cardia appears to share important epidemiologic features with esophageal cancer.
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Affiliation(s)
- F Levi
- Registre Vaudois des Tumeurs, Institut Universitaire de médecine sociale et préventive, Lausanne, Switzerland
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10
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La Vecchia C, Negri E, Parazzini F, Marubini E, Trichopolous D. Diet and Cancer Risk in Northern Italy: An Overview from Various Case-Control Studies. TUMORI JOURNAL 2018; 76:306-10. [DOI: 10.1177/030089169007600402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Carlo La Vecchia
- Istituto di Ricerche Farmacologiche « Mario Negri », Milan
- Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland
| | - Eva Negri
- Istituto di Ricerche Farmacologiche « Mario Negri », Milan
| | | | - Ettore Marubini
- Istituto di Biometria e Statistica Medica, Istituto Nazionale Tumori, Milano
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11
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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: 1.4] [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]
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12
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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: 1.3] [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.
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13
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BACANLI M, BAŞARAN N, BAŞARAN AA. Lycopene: Is it Beneficial to Human Health as an Antioxidant? Turk J Pharm Sci 2017; 14:311-318. [PMID: 32454630 PMCID: PMC7227929 DOI: 10.4274/tjps.43043] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/01/2016] [Indexed: 12/31/2022]
Abstract
It is well known that free oxygen radicals play an important role in the pathogenesis of several chronic disorders. Antioxidants are known as potential scavengers of reactive oxygen species that can protect biologic membranes against oxidative damage. Recent interest in phytochemicals has increased because of their protective effects against free oxygen radicals. Lycopene, which belongs to the carotenoid family, is the most effective singlet oxygen scavenger in vitro of all the carotenoids. Foods that contain lycopene and related supplements have been reported to prevent chronic diseases including cancer, asthma, and cardiovascular disorders. The aim of the article was to give a brief review of the antioxidant properties and beneficial health effects of lycopene.
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Affiliation(s)
- Merve BACANLI
- Hacettepe University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Nurşen BAŞARAN
- Hacettepe University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - A. Ahmet BAŞARAN
- Hacettepe University, Faculty of Pharmacy, Department of Pharmacognosy, Ankara, Turkey
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14
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Günes-Bayir A, Kiziltan HS. Palliative Vitamin C Application in Patients with Radiotherapy-Resistant Bone Metastases: A Retrospective Study. Nutr Cancer 2015; 67:921-5. [PMID: 26168394 DOI: 10.1080/01635581.2015.1055366] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The aim of this study was to observe effects of ascorbic acid application on pain, performance status, and survival time in cancer patients. A retrospective cohort of 39 patients with bone metastases treated with radiotherapy was identified. All patients were radiotherapy-resistant. Fifteen patients who received chemotherapy, and 15 patients who received an infusion of 2.5 g ascorbic acid were included in the study. Nine control patients were treated with neither chemotherapy nor vitamin C. Eastern Cooperative Oncology Group Performance Status Scale and Visual Analog Scale were used to determine performance status and pain assessments. Survival time and rate in patients were defined. Statistical analyses were performed to compare the results of groups. Performance status was increased in 4 patients of vitamin C group and 1 patient of chemotherapy group, whereas performance status in control group was decreased. A median reduction of 50% in pain was observed among the patients in the vitamin C group. Median survival time was 10 mo in patients receiving ascorbic acid, whereas the chemotherapy and control groups had a median survival of 2 mo. Intravenous vitamin C application seems to reduce pain in patients in comparison to other patients who did not receive it. Patient performance status and survival rate were increased using vitamin C.
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Affiliation(s)
- Ayse Günes-Bayir
- a Department of Nutrition and Dietetics , Faculty of Health Sciences, Bezmialem Vakif University , Fatih , Istanbul , Turkey
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15
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Guo Y, Shan Z, Ren H, Chen W. Dairy Consumption and Gastric Cancer Risk: A Meta-Analysis of Epidemiological Studies. Nutr Cancer 2015; 67:555-68. [DOI: 10.1080/01635581.2015.1019634] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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16
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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: 1.4] [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.
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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.
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Garai J, Uddo RB, Mohler MC, Pelligrino N, Scribner R, Sothern MS, Zabaleta J. At the crossroad between obesity and gastric cancer. Methods Mol Biol 2015; 1238:689-707. [PMID: 25421687 DOI: 10.1007/978-1-4939-1804-1_36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Obesity has reached epidemic proportions worldwide with disproportionate prevalence in different communities and ethnic groups. Recently, the American Medical Association recognized obesity as a disease, which is a significant milestone that opens the possibilities of treating obesity under standardized health plans. Obesity is an inflammatory disease characterized by elevated levels of biomarkers associated with abnormal lipid profiles, glucose levels, and blood pressure that lead to the onset of metabolic syndrome. Interestingly, inflammatory biomarkers, in particular, have been implicated in the risk of developing several types of cancer. Likewise, obesity has been linked to esophageal, breast, gallbladder, kidney, pancreatic, and colorectal cancers. Thus, there exists a link between obesity status and tumor appearance, which may be associated to the differential levels and the circulating profiles of several inflammatory molecules. For example, mediators of the inflammatory responses in both obesity and gastric cancer risk are the same: pro-inflammatory molecules produced by the activated cells infiltrating the inflamed tissues. These molecules trigger pathways of activation shared by obesity and cancer. Therefore, understanding how these different pathways are modulated would help reduce the impact that both diseases, and their concomitant existence, have on society.
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Affiliation(s)
- Jone Garai
- Stanley S. Scott Cancer Center, Louisiana Cancer Research Center, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
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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: 21] [Impact Index Per Article: 1.9] [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.
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Barzi A, Thara E. Angiogenesis in esophageal and gastric cancer: a paradigm shift in treatment. Expert Opin Biol Ther 2014; 14:1319-32. [DOI: 10.1517/14712598.2014.921677] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Abstract
Since its discovery in 1982, the global importance of Helicobacter pylori-induced disease, particularly in developing countries, remains high. The use of rodent models, particularly mice, and the unanticipated usefulness of the gerbil to study H. pylori pathogenesis have been used extensively to study the interactions of the host, the pathogen, and the environmental conditions influencing the outcome of persistent H. pylori infection. Dietary factors in humans are increasingly recognized as being important factors in modulating progression and severity of H. pylori-induced gastric cancer. Studies using rodent models to verify and help explain mechanisms whereby various dietary ingredients impact disease outcome should continue to be extremely productive.
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Affiliation(s)
- James G. Fox
- Division of Comparative Medicine, Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Timothy C. Wang
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York
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21
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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: 60] [Impact Index Per Article: 5.0] [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.
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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
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Zhu H, Yang X, Zhang C, Zhu C, Tao G, Zhao L, Tang S, Shu Z, Cai J, Dai S, Qin Q, Xu L, Cheng H, Sun X. Red and processed meat intake is associated with higher gastric cancer risk: a meta-analysis of epidemiological observational studies. PLoS One 2013; 8:e70955. [PMID: 23967140 PMCID: PMC3743884 DOI: 10.1371/journal.pone.0070955] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 06/26/2013] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Red and processed meat was concluded as a limited-suggestive risk factor of gastric cancer by the World Cancer Research Fund. However, recent epidemiological studies have yielded inconclusive results. METHODS We searched Medline, EMBASE, and the Cochrane Library from their inception to April 2013 for both cohort and case-control studies which assessed the association between red and/or processed meat intake and gastric cancer risk. Study-specific relative risk estimates were polled by random-effect or fixed-effect models. RESULTS Twelve cohort and thirty case-control studies were included in the meta-analysis. Significant associations were found between both red (RR: 1.45, 95% CI: 1.22-1.73) and processed (RR: 1.45, 95% CI: 1.26-1.65) meat intake and gastric cancer risk generally. Positive findings were also existed in the items of beef (RR: 1.28, 95% CI: 1.04-1.57), bacon (RR: 1.37, 95% CI: 1.17-1.61), ham (RR: 1.44, 95% CI: 1.00-2.06), and sausage (RR: 1.33, 95% CI: 1.16-1.52). When conducted by study design, the association was significant in case-control studies (RR: 1.63, 95% CI: 1.33-1.99) but not in cohort studies (RR: 1.02, 95% CI: 0.90-1.17) for red meat. Increased relative risks were seen in high-quality, adenocarcinoma, cardia and European-population studies for red meat. And most subgroup analysis confirmed the significant association between processed meat intake and gastric cancer risk. CONCLUSIONS Our findings indicate that consumption of red and/or processed meat contributes to increased gastric cancer risk. However, further investigation is needed to confirm the association, especially for red meat.
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Affiliation(s)
- Hongcheng Zhu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xi Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chi Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Zhu
- Department of Epidemiology and Biostatistics and Ministry of Education Key Laboratory for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Guangzhou Tao
- Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China
| | - Lianjun Zhao
- The Comprehensive Cancer Center, Nanjing Drum Tower Hospital and Clinical College of Nanjing Medical University, Nanjing, China
| | - Shaowen Tang
- Department of Epidemiology and Biostatistics and Ministry of Education Key Laboratory for Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zheng Shu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Jing Cai
- Tumor Institute, Nantong Tumor Hospital, Nantong, China
| | - Shengbin Dai
- Department of Oncology, Taizhou People's Hospital, Taizhou, China
| | - Qin Qin
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Liping Xu
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hongyan Cheng
- Department of Synthetic Internal Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinchen Sun
- Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Wu QJ, Yang Y, Wang J, Han LH, Xiang YB. Cruciferous vegetable consumption and gastric cancer risk: a meta-analysis of epidemiological studies. Cancer Sci 2013; 104:1067-73. [PMID: 23679348 PMCID: PMC7657120 DOI: 10.1111/cas.12195] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/03/2013] [Accepted: 05/08/2013] [Indexed: 12/13/2022] Open
Abstract
The relationship between consumption of cruciferous vegetables (CV) and risk of gastric cancer has been investigated by many studies, but remains controversial. We carried out a meta-analysis to summarize available evidence from epidemiological studies on this point. Relevant published reports of CV intake and gastric cancer were identified using MEDLINE (PubMed), EMBASE, and Web of Science databases through to the end of September 2012. We pooled the relative risk from individual studies using a fixed- or random-effects model and carried out heterogeneity and publication bias analyses. Sixteen case-control and six prospective studies were included in our analysis. When all studies were pooled, we yielded a significantly inverse association between CV (relative risk = 0.81; 95% confidence interval, 0.75-0.88) intake and gastric cancer risk, with little heterogeneity (Q = 27.27, P = 0.292, I(2) = 12.0%). Specific analysis for cabbage intake yielded similar result. When separately analyzed, case-control studies of CV intake yielded significant results and the results of prospective studies showed borderline statistical significance. Moreover, significant results were consistent for high-quality studies, for North American, European, and Asian studies, for studies on males, and for studies on non-cardia gastric cancer. Findings from this meta-analysis provide evidence that high intake of CV was inversely associated with the risk of gastric cancer and non-cardia gastric cancer in humans. Further studies on other specific CV, food preparation methods, and stratified results by anatomic cancer site and histological type should be extended in the future.
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Affiliation(s)
- Qi-Jun Wu
- State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Bertuccio P, Rosato V, Andreano A, Ferraroni M, Decarli A, Edefonti V, La Vecchia C. Dietary patterns and gastric cancer risk: a systematic review and meta-analysis. Ann Oncol 2013; 24:1450-8. [PMID: 23524862 DOI: 10.1093/annonc/mdt108] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Declines in gastric cancer (GC) incidence and mortality have been related to improvements in diet. It is therefore important to consider dietary patterns. DESIGN We conducted a systematic review and meta-analysis of the literature through Medline and Embase databases. RESULTS We identified 16 papers, of these 9 derived dietary patterns through an a posteriori method, 5 through a priori scores, and 2 used both approaches. Eight studies that used the a posteriori approach were considered for the meta-analysis. A favorable role on GC emerged for the 'Prudent/healthy', with an odds ratio (OR) of 0.75 [95% confidence interval (CI): 0.63-0.90], for the highest versus the lowest category. Similar results emerged for separate anatomical subtypes. An unfavorable role on GC emerged for the 'Western/unhealthy' dietary pattern, with an OR of 1.51 (95% CI: 1.21-1.89). This association was weaker for the distal/NOS (not otherwise specified) category (OR = 1.36) compared with the cardia GC (OR = 2.05). Among the a priori scores, the ORs ranged from 0.2 to 0.7 for the favorable and from 1.8 to 6.9 for the unfavorable ones. CONCLUSION There is a ~2-fold difference in GC risk between a 'Prudent/healthy' diet-rich in fruits and vegetables, and a 'Western/unhealthy' diet-rich in starchy foods, meat and fats.
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Affiliation(s)
- P Bertuccio
- Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, Milan, Italy.
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Yang T, Yang X, Wang X, Wang Y, Song Z. The role of tomato products and lycopene in the prevention of gastric cancer: a meta-analysis of epidemiologic studies. Med Hypotheses 2013; 80:383-8. [PMID: 23352874 DOI: 10.1016/j.mehy.2013.01.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/03/2013] [Accepted: 01/05/2013] [Indexed: 01/28/2023]
Abstract
BACKGROUND Gastric cancer is the second most common cause of death from cancer worldwide. Epidemiologic studies have examined the possible association between tomato products consumption and gastric cancer, but the relationship between tomato products and the risk of gastric cancer is controversial. We performed a meta-analysis of cohort and case-control studies to analyze this association. METHODS We systematically searched MEDLINE and EMBASE and contacted authors to identify potential studies published from January 1966 to June 2012. We pooled the relative risks from individual studies using a random-effects model and performed heterogeneity and publication bias analyses. RESULTS Twenty-one studies were eligible for our inclusion criteria, in a pooled analysis of all studies, consumption of large amounts of tomato products (in a comparison of the highest and lowest consumption groups) reduced the risk for gastric cancer (odds ratio, 0.73; 95% confidence interval, 0.60-0.90). The pooled OR of lycopene consumption and serum lycopene was 0.88 (95% CI=0.67-1.16) and 0.79 (95% CI=0.59-1.07), respectively. CONCLUSIONS Consumption of large amounts of tomato products is associated with a reduced risk of gastric cancer. However, because of potential confounding factors and exposure misclassification, further studies are required to establish these findings.
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Affiliation(s)
- Tingsong Yang
- Department of Hepatobiliary & Pancreatic Surgery, Shanghai Tenth Peoples' Hospital, Tongji University, Shanghai, PR China.
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Giordano A, Cito L. Advances in gastric cancer prevention. World J Clin Oncol 2012; 3:128-36. [PMID: 23061031 PMCID: PMC3468701 DOI: 10.5306/wjco.v3.i9.128] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 08/19/2012] [Accepted: 09/06/2012] [Indexed: 02/06/2023] Open
Abstract
Gastric cancer is a multifactorial neoplastic pathology numbering among its causes both environmental and genetic predisposing factors. It is mainly diffused in South America and South-East Asia, where it shows the highest morbility percentages and it is relatively scarcely diffused in Western countries and North America. Although molecular mechanisms leading to gastric cancer development are only partially known, three main causes are well characterized: Helicobacter pylori (H. pylori) infection, diet rich in salted and/or smoked food and red meat, and epithelial cadherin (E-cadherin) mutations. Unhealthy diet and H. pylori infection are able to induce in stomach cancer cells genotypic and phenotypic transformation, but their effects may be crossed by a diet rich in vegetables and fresh fruits. Various authors have recently focused their attention on the importance of a well balanced diet, suggesting a necessary dietary education starting from childhood. A constant surveillance will be necessary in people carrying E-cadherin mutations, since they are highly prone in developing gastric cancer, also within the inner stomach layers. Above all in the United States, several carriers decided to undergo a gastrectomy, preferring changing their lifestyle than living with the awareness of the development of a possible gastric cancer. This kind of choice is strictly personal, hence a decision cannot be suggested within the clinical management. Here we summarize the key points of gastric cancer prevention analyzing possible strategies referred to the different predisposing factors. We will discuss about the effects of diet, H. pylori infection and E-cadherin mutations and how each of them can be handled.
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Affiliation(s)
- Antonio Giordano
- Antonio Giordano, Letizia Cito, INT-CROM, "Pascale Foundation" National Cancer Institute-Cancer Research Center, 83013 Mercogliano, Italy
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Kim J, Park S, Nam BH. Gastric cancer and salt preference: a population-based cohort study in Korea. Am J Clin Nutr 2010; 91:1289-93. [PMID: 20219954 DOI: 10.3945/ajcn.2009.28732] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although the incidence of gastric cancer is declining, it remains the most common cancer in Korea. There have been discrepancies in epidemiologic studies regarding a causal relation between highly salted food and the risk of gastric cancer. OBJECTIVE The aim of this study was to assess the effect of salt preference on the incidence of gastric cancer in Korean adults through a population-based, prospective cohort study. DESIGN Participants were Korean government employees, school faculty members, and their unemployed dependents, aged 30-80 y, who underwent health examinations between 1996 and 1997. In 2003, information on the gastric cancer incidence in these participants was obtained during the 6-7-y follow-up period. The final data analysis included 2,248,129 study subjects. The hazard ratio (HR) and 95% CI of the HR were estimated by using the Cox proportional hazards regression model. RESULTS The age-standardized incidence rates per 100,000 person-years for the overall total population, men only, and women only were 97.64, 136.03, and 52.90, respectively. The Cox proportional hazards regression model, with adjustment for possible confounding factors, showed evidence of an increased risk of gastric cancer with salt preference. The HRs were 1.10 (95% CI: 1.04, 1.16) and 1.10 (95% CI: 1.03, 1.17) for the overall total population and men only, respectively. CONCLUSION The current findings suggest that salt preference has a marginal positive association with a risk of gastric cancer.
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Affiliation(s)
- Jeongseon Kim
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Management, National Cancer Center Research Institute, Goyang-si, Gyeonggi-do, South Korea
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Bertuccio P, Chatenoud L, Levi F, Praud D, Ferlay J, Negri E, Malvezzi M, La Vecchia C. Recent patterns in gastric cancer: a global overview. Int J Cancer 2009; 125:666-73. [PMID: 19382179 DOI: 10.1002/ijc.24290] [Citation(s) in RCA: 484] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Until the mid-1990s, gastric cancer has been the first cause of cancer death worldwide, although rates had been declining for several decades and gastric cancer has become a relatively rare cancer in North America and in most Northern and Western Europe, but not in Eastern Europe, Russia and selected areas of Central and South America or East Asia. We analyzed gastric cancer mortality in Europe and other areas of the world from 1980 to 2005 using joinpoint regression analysis, and provided updated site-specific incidence rates from 51 selected registries. Over the last decade, the annual percent change (APC) in mortality rate was around -3, -4% for the major European countries. The APC were similar for the Republic of Korea (APC = -4.3%), Australia (-3.7%), the USA (-3.6%), Japan (-3.5%), Ukraine (-3%) and the Russian Federation (-2.8%). In Latin America, the decline was less marked, but constant with APC around -1.6% in Chile and Brazil, -2.3% in Argentina and Mexico and -2.6% in Colombia. Cancers in the fundus and pylorus are more common in high incidence and mortality areas and have been declining more than cardia gastric cancer. Steady downward trends persist in gastric cancer mortality worldwide even in middle aged population, and hence further appreciable declines are likely in the near future.
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Affiliation(s)
- Paola Bertuccio
- Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
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Wang XQ, Terry PD, Yan H. Review of salt consumption and stomach cancer risk: epidemiological and biological evidence. World J Gastroenterol 2009; 15:2204-13. [PMID: 19437559 PMCID: PMC2682234 DOI: 10.3748/wjg.15.2204] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 03/23/2009] [Accepted: 03/30/2009] [Indexed: 02/06/2023] Open
Abstract
Stomach cancer is still the fourth most common cancer; thus, it remains an important public health burden worldwide, especially in developing countries. The remarkable geographic variations in the rates of stomach cancer indicate that dietary factors, including a range of food groups to which salt and/or nitrates have been added, may affect stomach cancer risk. In this paper, we review the results from ecologic, case-control and cohort studies on the relationship between salt or salted foods and stomach cancer risk. The majority of ecological studies indicated that the average salt intake in each population was closely correlated with gastric cancer mortality. Most case-control studies showed similar results, indicating a moderate to high increase in risk for the highest level of salt or salted food consumption. The overall results from cohort studies are not totally consistent, but are suggestive of a moderate direct association. Since salt intake has been correlated with Helicobacter pylori (H pylori) infection, it is possible that these two factors may synergize to promote the development of stomach cancer. Additionally, salt may also cause stomach cancer through directly damaging gastric mucus, improving temporary epithelial proliferation and the incidence of endogenous mutations, and inducing hypergastrinemia that leads to eventual parietal cell loss and progression to gastric cancer. Based on the considerable evidence from ecological, case-control and cohort studies worldwide and the mechanistic plausibility, limitation on salt and salted food consumption is a practical strategy for preventing gastric cancer.
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Gallus S, Tramacere I, Tavani A, Bosetti C, Bertuccio P, Negri E, La Vecchia C. Coffee, black tea and risk of gastric cancer. Cancer Causes Control 2009; 20:1303-8. [PMID: 19430969 DOI: 10.1007/s10552-009-9350-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 04/14/2009] [Indexed: 01/26/2023]
Abstract
BACKGROUND To provide information about the association of coffee, black tea with gastric cancer risk. METHODS Between 1985 and 2007, we conducted two case-control studies in northern Italy. Overall, cases were 999 subjects with incident, histologically confirmed gastric cancer and controls were 2,628 patients admitted to the same network of hospitals for acute non-neoplastic diseases. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) for coffee (mostly espresso and mocha) and black tea consumption were estimated after allowance for socio-demographic data, smoking, and other major covariates of interest. RESULTS When compared with non-coffee drinkers, the OR was 0.94 (95% CI: 0.73-1.22) for drinkers of one cup of coffee per day, 1.03 (95% CI: 0.80-1.32) for two, 1.07 (95% CI: 0.82-1.40) for three, and 1.24 (95% CI: 0.94-1.65) for four or more cups per day. No association was found with reference to duration of coffee consumption, or consumption of decaffeinated coffee. When compared with non-black-tea drinkers, the OR was 0.89 (95% CI: 0.56-1.42) for drinkers of two or more cups of black tea per day. CONCLUSIONS Our investigation, based on a uniquely large dataset, provides convincing evidence that coffee and black tea consumption is unlikely to be strongly associated with gastric cancer risk.
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Affiliation(s)
- Silvano Gallus
- Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa 19, 20156, Milan, Italy.
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Dietary fiber and stomach cancer risk: a case–control study from Italy. Cancer Causes Control 2009; 20:847-53. [DOI: 10.1007/s10552-009-9309-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 01/30/2009] [Indexed: 12/31/2022]
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Bertuccio P, Praud D, Chatenoud L, Lucenteforte E, Bosetti C, Pelucchi C, Rossi M, Negri E, La Vecchia C. Dietary glycemic load and gastric cancer risk in Italy. Br J Cancer 2009; 100:558-61. [PMID: 19190635 PMCID: PMC2658547 DOI: 10.1038/sj.bjc.6604894] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
We investigated gastric cancer risk in relation to dietary glycemic index (GI) and glycemic load (GL), which represent indirect measures of carbohydrate absorption and consequently of dietary insulin demand, in a case-control study conducted in northern Italy between 1997 and 2007, including 230 patients with the incident, histologically confirmed gastric cancer and 547 frequency matched controls, admitted to the same hospitals as cases with acute non-neoplastic conditions. We used conditional logistic regression models, including terms for major recognised gastric cancer risk factors and non-carbohydrate energy intake. The odds ratios (ORs) in the highest vs lowest quintile were 1.9 (95% CI: 1.0–3.3) for GI and 2.5 (95% CI: 1.3–4.9) for GL. Compared with participants reporting low GL and high fruits/vegetables intake, the OR rose across strata of high GL and low fruits/vegetables, to reach 5.0 (95% CI: 2.2–11.5) for those reporting low fruits/vegetables intake and high GL. Our study may help to explain the direct relation observed in several studies between starchy foods and gastric cancer risk.
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Affiliation(s)
- P Bertuccio
- Istituto di Ricerche Farmacologiche Mario Negri, Via Giuseppe La Masa, 19, 20156 Milan, Italy.
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Abstract
Data from epidemiologic, experimental, and animal studies indicate that diet plays an important role in the etiology of gastric cancer. High intake of fresh fruits and vegetables, lycopene and lycopene-containing food products, and potentially vitamin C and selenium may reduce the risk for gastric cancer. Data also suggest that high intake of nitrosamines, processed meat products, salt and salted foods, and overweight and obesity are associated with increased risk for gastric cancer. However, current data provide little support for an association of beta-carotene, vitamin E, and alcohol consumption with risk for gastric cancer.
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Affiliation(s)
- Chun Liu
- Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA.
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Citrus fruit intake and stomach cancer risk: a quantitative systematic review. Gastric Cancer 2008; 11:23-32. [PMID: 18373174 DOI: 10.1007/s10120-007-0447-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Accepted: 12/03/2007] [Indexed: 02/07/2023]
Abstract
BACKGROUND The purpose of this systematic review was to investigate the association between dietary intake of citrus fruits and gastric cancer risk. METHODS We searched electronic databases and the reference lists of publications on diet and stomach cancer studies until April 2007. All of the epidemiological studies that obtained individual data on dietary intake of citrus fruits and presented risk estimates of the association between intake of citrus fruits and risk of stomach cancer were identified and included in this review. Using general variance-based methods, study-specific odds ratio (OR)/ relative risk (RR) and associated confidence interval (CI)/ standard error (SE) for highest versus lowest intake of citrus fruits level were extracted from each article. RESULTS Fourteen articles, including six hospital-based case-control studies, six community-based case-control studies, and two cohort studies, proved eligible. Overall summary OR using a fixed-effect model showed a 28% reduction in risk of stomach cancer associated with high intake of citrus fruits (summary OR = 0.72; 95% CI = 0.64-0.81; P value <0.0001); results were consistent across studies (I(2) = 0, where I(2) describes the percentage of total variation across studies because of heterogeneity rather than chance). Also, visual inspection of the results did not suggest a publication bias. CONCLUSION Pooled results from observational studies support a protective effect of high citrus fruit intake in the risk of stomach cancer.
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De Vries AC, Kuipers EJ. Review article: Helicobacter pylori eradication for the prevention of gastric cancer. Aliment Pharmacol Ther 2007; 26 Suppl 2:25-35. [PMID: 18081646 DOI: 10.1111/j.1365-2036.2007.03475.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gastric cancer is the fourth most common cancer and second leading cause of cancer-related death worldwide. A clear association between Helicobacter pylori infection and gastric cancer was established years ago. H. pylori eradication may be an effective approach to decrease morbidity and mortality of gastric cancer. AIM To discuss current evidence of H. pylori eradication for prevention of gastric cancer. RESULTS Recent studies have shown that the association between H. pylori and gastric cancer has probably been underestimated. This may have resulted from negative H. pylori status in subjects after loss of colonisation in the presence of atrophic gastritis and intestinal metaplasia, prior to development of gastric cancer. The recognition of the central role of H. pylori in carcinogenesis has increased expectations of gastric cancer prevention by H. pylori eradication. A primary preventive effect of eradication in subjects with H. pylori-induced gastritis has been demonstrated. However, a secondary preventive effect in patients with pre-malignant gastric lesions is still controversial, especially in patients with intestinal metaplasia and dysplasia. CONCLUSIONS At this moment, H. pylori eradication seems indicated at the earliest stage of gastric carcinogenesis. This treatment policy requires confirmation; results of ongoing randomised controlled trials are therefore eagerly awaited.
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Affiliation(s)
- A C De Vries
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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Kavanaugh CJ, Trumbo PR, Ellwood KC. The U.S. Food and Drug Administration's evidence-based review for qualified health claims: tomatoes, lycopene, and cancer. J Natl Cancer Inst 2007; 99:1074-85. [PMID: 17623802 DOI: 10.1093/jnci/djm037] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Several studies have reported an inverse association between tomato and/or lycopene intake and the risk of some types of cancer. In 2004, the U.S. Food and Drug Administration (FDA) received two petitions for qualified health claims regarding tomatoes, lycopene, and the risk reduction for some forms of cancer. Health claims that characterize the relationship between a food or food component and a disease or health-related condition require premarket approval by FDA to be included on the labels of conventional foods and dietary supplements. Here we describe FDA's review of the scientific data for tomato and/or lycopene intake with respect to risk reduction for certain forms of cancer. The FDA found no credible evidence to support an association between lycopene intake and a reduced risk of prostate, lung, colorectal, gastric, breast, ovarian, endometrial, or pancreatic cancer. The FDA also found no credible evidence for an association between tomato consumption and a reduced risk of lung, colorectal, breast, cervical, or endometrial cancer. The FDA found very limited evidence to support an association between tomato consumption and reduced risks of prostate, ovarian, gastric, and pancreatic cancers.
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Affiliation(s)
- Claudine J Kavanaugh
- RD, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, HFS-830, 5100 Paint Branch Parkway, College Park, MD 20740, USA.
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Abstract
Regular consumption of whole grain foods has been associated with a reduction in the incidence of cardiovascular disease and diabetes, reductions in cancer mortality at certain sites and an overall reduction in premature death. Although benefits are observed at relatively low levels of intake (between two and three servings per d), the consumption of whole grain foods in some Western countries is less than one serving per d. The main sources of whole grain are wholemeal and rye breads and whole grain breakfast cereals. Typical consumers of whole-grain foods tend to be older, from a high socio-economic group, are less likely to smoke and are more likely to exercise than non-consumers. Some of these attributes may contribute to the observed health benefits. However whole grain foods are an important source of a range of nutrients as part of a healthy eating plan. There is considerable scope for strategies to promote increased consumption of whole grain foods to reduce the risk of a variety of chronic diseases
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Affiliation(s)
- Rebecca Lang
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
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Basu A, Imrhan V. Tomatoes versus lycopene in oxidative stress and carcinogenesis: conclusions from clinical trials. Eur J Clin Nutr 2006; 61:295-303. [PMID: 16929242 DOI: 10.1038/sj.ejcn.1602510] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To review the effects of tomato product supplementation, containing lycopene, on biomarkers of oxidative stress and carcinogenesis in human clinical trials. RESULTS Supplementation of tomato products, containing lycopene, has been shown to lower biomarkers of oxidative stress and carcinogenesis in healthy and type II diabetic patients, and prostate cancer patients, respectively. Processed tomato products like tomato juice, tomato paste, tomato puree, tomato ketchup and tomato oleoresin have been shown to provide bioavailable sources of lycopene, with consequent increases in plasma lycopene levels versus baseline. Dietary fats enhance this process and should be consumed together with food sources of lycopene. The mechanisms of action involve protection of plasma lipoproteins, lymphocyte DNA and serum proteins against oxidative damage, and anticarcinogenic effects, including reduction of prostate-specific antigen, upregulation of connexin expression and overall decrease in prostate tumor aggressiveness. There is limited in vivo data on the health benefits of lycopene alone. Most of the clinical trials with tomato products suggest a synergistic action of lycopene with other nutrients, in lowering biomarkers of oxidative stress and carcinogenesis. CONCLUSIONS Consumption of processed tomato products, containing lycopene, is of significant health benefit and can be attributed to a combination of naturally occurring nutrients in tomatoes. Lycopene, the main tomato carotenoid, contributes to this effect, but its role per se remains to be investigated.
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Affiliation(s)
- A Basu
- Medical Pathology, UCDavis Health System, Sacramento, CA, USA
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Larsson SC, Orsini N, Wolk A. Processed meat consumption and stomach cancer risk: a meta-analysis. J Natl Cancer Inst 2006; 98:1078-87. [PMID: 16882945 DOI: 10.1093/jnci/djj301] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The relationship between processed meat consumption and the risk of stomach cancer is controversial. We conducted a meta-analysis to summarize available evidence from cohort and case-control studies on this issue. METHODS We searched Medline for studies of processed meat consumption and stomach cancer published from January 1966 through March 2006. Random-effects models were used to pool the relative risks from individual studies. All statistical tests were two-sided. RESULTS Six prospective cohort studies (involving 2209 stomach cancer patients) and nine case-control studies (2495 case patients) were eligible for inclusion in the dose-response meta-analysis of processed meat consumption. The estimated summary relative risks of stomach cancer for an increase in processed meat consumption of 30 g/day, approximately half of an average serving, were 1.15 (95% confidence interval [CI] = 1.04 to 1.27) for the cohort studies and 1.38 (95% CI = 1.19 to 1.60) for the case-control studies. There was no statistically significant heterogeneity among the cohort studies (P = .42) or among the case-control studies (P = .19). In three cohort and four case-control studies that examined the association between bacon consumption and stomach cancer, the summary relative risk was 1.37 (95% CI = 1.17 to 1.61) for the highest versus lowest intake categories of bacon, without heterogeneity among these studies (P = .66). CONCLUSION Increased consumption of processed meat is associated with an increased risk of stomach cancer. However, the possibility that the association may be confounded or modified by other factors cannot be ruled out.
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Affiliation(s)
- Susanna C Larsson
- Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
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Larsson SC, Bergkvist L, Wolk A. Processed meat consumption, dietary nitrosamines and stomach cancer risk in a cohort of Swedish women. Int J Cancer 2006; 119:915-9. [PMID: 16550597 DOI: 10.1002/ijc.21925] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Processed meat consumption has been associated with an increased risk of stomach cancer in some epidemiological studies (mainly case-control). Nitrosamines may be responsible for this association, but few studies have directly examined nitrosamine intake in relation to stomach cancer risk. We prospectively investigated the associations between intakes of processed meat, other meats and N-nitrosodimethylamine (the most frequently occurring nitrosamine in foods) with risk of stomach cancer among 61,433 women who were enrolled in the population-based Swedish Mammography Cohort. Information on diet was collected at baseline (between 1987 and 1990) and updated in 1997. During 18 years of follow-up, 156 incident cases of stomach cancer were ascertained. High consumption of processed meat, but not of other meats (i.e., red meat, fish and poultry), was associated with a statistically significant increased risk of stomach cancer. After adjustment for potential confounders, the hazard ratios for the highest compared with the lowest category of intake were 1.66 (95% CI = 1.13-2.45) for all processed meats, 1.55 (95% CI = 1.00-2.41) for bacon or side pork, 1.50 (95% CI = 0.93-2.41) for sausage or hotdogs and 1.48 (95% CI= 0.99-2.22) for ham or salami. Stomach cancer risk was 2-fold higher among women in the top quintile of N-nitrosodimethylamine intake when compared with those in the bottom quintile (hazard ratio = 1.96; 95% CI = 1.08-3.58). Our findings suggest that high consumption of processed meat may increase the risk of stomach cancer. Dietary nitrosamines might be responsible for the positive association.
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Affiliation(s)
- Susanna C Larsson
- Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Shikata K, Kiyohara Y, Kubo M, Yonemoto K, Ninomiya T, Shirota T, Tanizaki Y, Doi Y, Tanaka K, Oishi Y, Matsumoto T, Iida M. A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population: the Hisayama study. Int J Cancer 2006; 119:196-201. [PMID: 16450397 DOI: 10.1002/ijc.21822] [Citation(s) in RCA: 179] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The results of prospective studies of the association between dietary salt intake and gastric cancer occurrence remain controversial. To examine this issue in a cohort study of a general population, 2,476 subjects aged 40 years or older were stratified into 4 groups according to the amount of daily salt intake: namely, <10.0, 10.0-12.9, 13.0-15.9, and > or = 16.0 per day and were followed up prospectively for 14 years. During the follow-up period, 93 subjects developed gastric cancer. The age- and sex-adjusted incidence was significantly higher in the second to fourth groups than in the first group (age- and sex-adjusted hazard ratio [95% confidence interval], 2.42 [1.24-4.71] for the second group; 2.10 [1.03-4.30] for the third group; 2.98 [1.53-5.82] for the fourth group). This association remained substantially unchanged even after adjusting for other confounding factors such as age, sex, Helicobacter pylori infection, atrophic gastritis, medical history of peptic ulcer, family history of cancer, body mass index, diabetes, total cholesterol, physical activity, alcohol intake, smoking habit and other dietary factors. In the stratified analysis, a significant salt-cancer association was observed only in subjects who had both Helicobacter pylori infection and atrophic gastritis (age- and sex-adjusted hazard ratio, 2.87 [1.14-7.24]). Our findings suggest that high dietary salt intake is a significant risk factor for gastric cancer; moreover, this association was found to be strong in the presence of Helicobacter pylori infection with atrophic gastritis.
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Affiliation(s)
- Kentaro Shikata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Botelho F, Lunet N, Barros H. Coffee and gastric cancer: systematic review and meta-analysis. CAD SAUDE PUBLICA 2006; 22:889-900. [PMID: 16680342 DOI: 10.1590/s0102-311x2006000500002] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
We systematically reviewed the literature on the association between coffee consumption and gastric cancer and performed a meta-analysis of the results. Published cohort and case-control studies were identified in PubMed and reference lists. Random effects meta-analysis was used to pool effects from 23 studies, and heterogeneity was explored by stratification and meta-regression. The odds ratio (OR) for the overall association between coffee and gastric cancer (highest vs. lowest category of exposure) was 0.97 (95%CI: 0.86-1.09), similar for cohort (OR = 1.02; 95%CI: 0.76-1.37) and case-control studies (population-based: OR = 0.90; 95%CI: 0.70-1.15; hospital-based: OR = 0.97; 95%CI: 0.83-1.13). The OR was 1.26 (95%CI: 1.02-1.57) when considering five studies conducted in the USA, 0.97 (95%CI: 0.82-1.14) for the five Japanese studies, 0.98 (95%CI: 0.81-1.17) for the six studies from Europe, and 0.64 (95%CI: 0.47-0.86) for the two studies from South America. In this meta-analysis we found no adverse effect of coffee associated with gastric cancer. Knowledge on the level of exposure to different coffee constituents may provide a deeper understanding of this reassuring result and the real role of coffee on cancer risk.
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YOU NAICHIEHYUKO, ZHANG ZUOFENG. Gastric Cancer. NUTRITIONAL ONCOLOGY 2006:437-447. [DOI: 10.1016/b978-012088393-6/50080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Tokui N, Yoshimura T, Fujino Y, Mizoue T, Hoshiyama Y, Yatsuya H, Sakata K, Kondo T, Kikuchi S, Toyoshima H, Hayakawa N, Kubo T, Tamakoshi A. Dietary habits and stomach cancer risk in the JACC Study. J Epidemiol 2005; 15 Suppl 2:S98-108. [PMID: 16127240 PMCID: PMC8639040 DOI: 10.2188/jea.15.s98] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND: Despite a declining incidence, stomach cancer is still a dominant cancer in Japan. The association between dietary habits and stomach cancer risk was investigated in a large prospective study in Japan. METHODS: Data were obtained using a self-administered questionnaire from 1988 through 1990. Food frequency questionnaire was used to evaluate the consumption of 33 selected food items. Proportional hazard model was used to determine the hazard ratios (HRs) and their 95% confidence intervals (CIs) of stomach cancer for different levels of the dietary intakes. RESULTS: A western style breakfast showed an inverse association with stomach cancer risk in males (HR=0.49, 95% CI: 0.35-0.70). Women who consumed liver three to four times per week and more than once per day had a significant increased risk, respectively (HR=2.02, 95% CI: 1.12-3.63, HR=3.16, 95% CI: 1.16-8.62 ). A clear dose-response relationship between the intake of liver and stomach cancer risk was observed. We found no association between stomach cancer mortality and the consumption of fruit such as mandarin orange, and vegetables such as carrots and spinach in both men and women. The consumption of high salt foods such as miso soup and pickles was also not significantly associated with the mortality of stomach cancer in both sexes. CONCLUSION: This prospective study suggested that a western-style breakfast is associated with a lower risk of stomach cancer, although some differences in the association were seen between men and women.
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Affiliation(s)
- Noritaka Tokui
- Department of Clinical Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan.
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Peri L, Pietraforte D, Scorza G, Napolitano A, Fogliano V, Minetti M. Apples increase nitric oxide production by human saliva at the acidic pH of the stomach: a new biological function for polyphenols with a catechol group? Free Radic Biol Med 2005; 39:668-81. [PMID: 16085185 DOI: 10.1016/j.freeradbiomed.2005.04.021] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Revised: 04/22/2005] [Accepted: 04/22/2005] [Indexed: 12/17/2022]
Abstract
Dietary inorganic nitrate is secreted in saliva and reduced to nitrite by bacterial flora. At the acidic pH of the stomach nitrite is present as nitrous acid in equilibrium with nitric oxide (*NO), and other nitrogen oxides with nitrating and nitrosating activity. *NO in the stomach exerts several beneficial effects, but nitrosating/nitrating species have been implicated as a possible cause of epithelial neoplasia at the gastroesophageal junction. We investigated the effects of apple extracts on *NO release by human saliva at pH 2. A water extract obtained from apple homogenate increased *NO release caused by acidification of saliva. Data show that polyphenols were responsible for this activity, with chlorogenic acid and (+)-catechin the most active and concentrated species. However, ferulic acid, a hydroxycinnamic acid with only one aromatic hydroxyl group, did not increase *NO release. Fructose, the most representative sugar in apples, was also inactive. Interestingly, ascorbic acid in saliva induced a SCN(-)-enhanced burst of *NO but, unlike apple, the release was transient. The simultaneous addition of ascorbic acid and apple extract caused a burst of *NO followed by the increased steady-state level characteristic of saliva containing apple extract. Chlorogenic acid and (+)-catechin, but not ferulic acid, formed o-semiquinone radicals and nitrated polyphenols, suggesting the scavenging of *NO(2) by o-semiquinones. Our results propose that some apple polyphenols not only inhibit nitrosation/nitration but also promote *NO bio-availabilty at the gastric level, a previously unappreciated function.
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Affiliation(s)
- Laura Peri
- Department of Cell Biology and Neuroscience, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
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Phukan RK, Zomawia E, Narain K, Hazarika NC, Mahanta J. Tobacco use and stomach cancer in Mizoram, India. Cancer Epidemiol Biomarkers Prev 2005; 14:1892-6. [PMID: 16103433 DOI: 10.1158/1055-9965.epi-05-0074] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The incidence of stomach cancer in India is lower than that of any other country around the world. However, in Mizoram, one of the north-eastern state of India, a very high age-adjusted incidence of stomach cancer is recorded. A hospital-based case-control study was carried out to identify the influence of tobacco use on the risk of developing stomach cancer in Mizoram. Among the cases, the risk of stomach cancer was significantly elevated among current smokers [odds ratio (OR), 2.3; 95% confidence interval (95% CI), 1.4-8.4] but not among ex-smokers. Higher risks were seen for meiziol (a local cigarette) smokers (OR, 2.2; 95% CI, 1.3-9.3). The increased risk was apparent among subjects who had smoked for >or=30 years. The increased risk was significant with 2-fold increase in risk among the subjects who smoked for >or=11 pack-years. The risk increased with increasing cumulative dose of tobacco smoked (mg). Tuibur (tobacco smoke-infused water), used mainly in Mizoram, was seemed to increased the risk of stomach cancer among current users in both univariate and multivariate models (OR, 2.1; 95% CI, 1.3-3.1). Tobacco chewer alone (OR, 2.6; 95% CI, 1.1-4.2) showed significant risk. Tobacco use in any form [smoking and smokeless (tuibur and chewing)] increased the risk of stomach cancer in Mizoram independently after adjusting for confounding variables.
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Affiliation(s)
- Rup Kumar Phukan
- Regional Medical Research Centre, N.E. Region (ICMR), PO Box 105, Dibrugarh 786 001, Assam, India
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Ishikawa M, Kitayama J, Kazama S, Hiramatsu T, Hatano K, Nagawa H. Plasma Adiponectin and Gastric Cancer. Clin Cancer Res 2005. [DOI: 10.1158/1078-0432.466.11.2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Abstract
Background: Recently, increased body weight has been associated with an increased risk of cancers at multiple specific sites, including gastric cancer. Adiponectin is a peptide hormone secreted by adipose tissue, affecting the proliferation and insulin sensitivity of various types of cells. Moreover, the circulating level of adiponectin has been reported to be inversely related to body mass index.
Methods: Fasting plasma levels of adiponectin were determined in 75 patients with gastric cancer and 52 healthy controls using an ELISA. In these patients, we analyzed the association between plasma adiponectin level and gastric cancer risk as well as various clinicopathologic characteristics.
Results: Plasma adiponectin level was significantly lower in patients with gastric cancer than in healthy controls (9.1 ± 6.2 versus 13.3 ± 9.4 ng/mL, P < 0.01) and showed a significant modest inverse relation with the gastric cancer (odds ratio, 0.92; 95% confidence interval, 0.85-0.97; adjusted odds ratio, 0.89; 95% confidence interval, 0.84-0.95], although body mass index was not different. In addition, adiponectin level was extremely low in patients with upper gastric cancers (upper, 5.5 ± 4.1 ng/mL; middle, 9.7 ± 6.4 ng/mL; lower, 10.7 ± 4.1 ng/mL; P = 0.012). Furthermore, adiponectin level tended to decrease as the tumor stage increased (stage I, 9.9 ± 6.9 ng/mL; stage II, 8.7 ± 5.5 ng/mL; stage III, 8.6 ± 4.1 ng/mL; stage IV, 5.2 ± 6.2 ng/mL; P = 0.34). Interestingly, in 32 patients with undifferentiated cancer, serum adiponectin showed a negative correlation with pathologic findings such as tumor size, depth of invasion, as well as tumor stage (P < 0.05), but no correlation in the remaining 43 patients with differentiated cancer.
Conclusions: Our results suggest that a low plasma adiponectin level is associated with an increased risk for gastric cancer and raise the possibility that adiponectin has a potential role in the progression of gastric cancer, especially in undifferentiated type cancers in the upper stomach.
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Affiliation(s)
- Makoto Ishikawa
- 1Department of Surgery, Division of Surgical Oncology, University of Tokyo, Bunkyo-ku, Tokyo, Japan and
| | - Joji Kitayama
- 1Department of Surgery, Division of Surgical Oncology, University of Tokyo, Bunkyo-ku, Tokyo, Japan and
| | - Shinsuke Kazama
- 2Department of Surgery, Yaizu Municipal Hospital, Yaizu-City, Shizuoka, Japan
| | - Takeyuki Hiramatsu
- 2Department of Surgery, Yaizu Municipal Hospital, Yaizu-City, Shizuoka, Japan
| | - Kenji Hatano
- 1Department of Surgery, Division of Surgical Oncology, University of Tokyo, Bunkyo-ku, Tokyo, Japan and
| | - Hirokazu Nagawa
- 1Department of Surgery, Division of Surgical Oncology, University of Tokyo, Bunkyo-ku, Tokyo, Japan and
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Koizumi Y, Tsubono Y, Nakaya N, Kuriyama S, Shibuya D, Matsuoka H, Tsuji I. Cigarette smoking and the risk of gastric cancer: a pooled analysis of two prospective studies in Japan. Int J Cancer 2004; 112:1049-55. [PMID: 15386347 DOI: 10.1002/ijc.20518] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To examine the association between cigarette smoking and the risk of gastric cancer, we conducted a pooled analysis of 2 population-based prospective cohort studies in rural northern Japan. Cohort 1 included 9,980 men (>or=40 years old) and Cohort 2 included 19,412 men (40-64 years old). The subjects completed a self-administered questionnaire on cigarette smoking and other health habits. We identified 228 cases of gastric cancer among Cohort 1 subjects (9 years of follow-up with 74,073 person-years) and 223 among Cohort 2 subjects (7 years of follow-up with 141,675 person-years). From each cohort, we computed the relative risk (RR) and 95% confidence interval (CI) of gastric cancer associated with smoking using a Cox regression analysis and pooled these estimates to obtain summary measures. The pooled multivariate RRs (95% CIs) for current smokers and past smokers compared to subjects who had never smoked were 1.84 (1.39-2.43) and 1.77 (1.29-2.43), respectively. The higher number of cigarettes smoked per day among current smokers was associated with a linear increase in risk (trend p < 0.05). The significant increase in risk for past smokers remained for up to 14 years after cessation. An increased risk was noted for cancer of the antrum but not for cardia or body lesions. The risk was increased for both differentiated and nondifferentiated histologic subtypes. Our findings support the hypothesis that cigarette smoking is a risk factor for gastric cancer.
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Affiliation(s)
- Yayoi Koizumi
- Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Augustin LSA, Gallus S, Negri E, La Vecchia C. Glycemic index, glycemic load and risk of gastric cancer. Ann Oncol 2004; 15:581-4. [PMID: 15033662 DOI: 10.1093/annonc/mdh130] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Dietary carbohydrates have been directly associated with gastric cancer risk and have been considered general indicators of a poor diet. However, elevated levels of glucose and insulin elicited by consumption of high amounts of refined carbohydrates may stimulate mitogenic and cancer-promoting insulin-like growth factors (IGF). Glycemic index (GI) and glycemic load (GL), which represent indirect measures of dietary insulin demand, were analysed to understand further the association between carbohydrates and gastric cancer. PATIENTS AND METHODS Data were derived from a hospital-based case-control study on gastric cancer, conducted in Italy between 1985 and 1997, including 769 cases with incident, histologically confirmed gastric cancer and 2081 controls admitted to the same hospital network as cases for acute, non-neoplastic diseases. All subjects were interviewed using a reproducible food frequency questionnaire. RESULTS The multivariate odds ratios (OR) for subsequent quartiles of dietary GL were 1.44 [95% confidence interval (CI) 1.11-1.87], 1.62 (95% CI 1.24-2.12) and 1.94 (95% CI 1.47-2.55). No consistent pattern of risk was seen with GI. The associations were consistent in different strata of age, education and body mass index, and were stronger in women. CONCLUSIONS This study supports the hypothesis of a direct association between GL and gastric cancer risk, thus providing an innovative interpretation, linked to excess circulating insulin and related IGFs, for the association between carbohydrates and risk of gastric cancer.
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Affiliation(s)
- L S A Augustin
- Servizio di Epidemiologiae Biostatistica, Centro di Riferimento Oncologico, Pordenone, Italy
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Lissowska J, Gail MH, Pee D, Groves FD, Sobin LH, Nasierowska-Guttmejer A, Sygnowska E, Zatonski W, Blot WJ, Chow WH. Diet and Stomach Cancer Risk in Warsaw, Poland. Nutr Cancer 2004; 48:149-59. [PMID: 15231449 DOI: 10.1207/s15327914nc4802_4] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Some of the world's highest rates of stomach cancer are found in Poland. Reasons for the increased incidence are not known, but high intake of sausages and other preserved foods and low intake of fresh fruits and vegetables may be involved. A case-control study comprising residents newly diagnosed with stomach cancer during 1994-96 and controls randomly selected from the general population was conducted in Warsaw, Poland. Standardized interviews were conducted to ascertain usual consumption of 118 common foods and beverages and other exposures. Using data from direct interviews with 274 cases and 463 controls, odds ratios of stomach cancer were calculated as estimates of risks associated with dietary factors, adjusting for age, sex, education, smoking, and caloric intake. Risk of stomach cancer was inversely related to intake of total fruits and dark green-yellow vegetables and to indices of vitamins C and E and alpha- and beta-carotenes. However, risk was not significantly increased among those with high intake of pickled/salted vegetables and sausages. Risks were positively associated with increased intake of breads/cereals/rice/pasta and other refined grains, as well as a high carbohydrate index. Our findings add to the evidence of a protective effect of fruits and certain vegetables on stomach cancer risk, but do not indicate that high intake of sausage and other preserved foods typical in the Polish diet has contributed to the country's elevated stomach cancer incidence. Our data also suggest that high carbohydrate consumption may influence risk, but further confirmation is needed.
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Affiliation(s)
- Jolanta Lissowska
- Division of Cancer Epidemiology and Prevention, Cancer Center and M. Sklodowska-Curie Institute of Oncology, Warsaw, Poland.
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