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Meta-analysis of smoking and the risk of gastric cancer among the Chinese population

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Clinical Oncology and Cancer Research

Abstract

Objective

To reevaluate the effect of tobacco smoking on the risk of developing gastric cancer among the Chinese population.

Methods

Thirty articles from the literature both in Chinese and English from January, 1988 to present were identified and from which adjusted odd ratios (ORs) or relative risks (RRs) were combined by meta-analysis. Generalized least squares (GLS) for trend estimation of summarized dose-response data was carried out. All the analyses were performed using software of STATA version 10.0.

Results

Comparing current smokers with subjects who have never smoked, the summary effect values on gastric cancer with a 95% confidence interval (CI) were 1.67 (1.43–1.96) for case-control studies and 1.52 (1.17–1.96) for cohort studies, respectively. The combined effect values with a 95%CI for the comparison of smoking quantity of current smokers with the referent group were 1.41 (1.15–1.72) for case-control studies and 1.24 (1.02–1.52) for cohort studies, respectively. The combined effect values with a 95%CI for the comparison of accumulative years smoked of current smokers with the referent group were 1.07 (0.89–1.28) for case-control studies and 1.28 (0.95–1.74) for cohort studies, respectively. Dose-response meta-analysis showed that the gastric cancer risk will increase 50% (OR = 1.50, 95%CI: 1.34–1.67) with each 20 cigarette per day increment and increase 14% (OR = 1.14, 95%CI: 1.10–1.18) with each 10 year increment of smoking.

Conclusion

The gastric cancer risk among the Chinese population is significantly associated with tobacco smoking and the smoking quantity per day. Smoking cessation should be more strongly advocated.

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References

  1. Yang L. Incidence and mortality of gastric cancer in China. World J Gastroenterol 2006; 12: 17–20.

    PubMed  Google Scholar 

  2. Lunet N, Lacerda-Vieira A, Barros H. Fruit and vegetables consumption and gastric cancer: a systematic review and meta-analysis of cohort studies. Nutr Cancer 2005; 53: 1–10.

    Article  PubMed  Google Scholar 

  3. Nutritional aspects of the development of cancer. Report of the Working Group on Diet and Cancer of the Committee on Medical Aspects of Food and Nutrition Policy. Rep Health Soc Subj (Lond) 1998; 48: i–xiv, 1–274.

    Google Scholar 

  4. Rocco A, Nardone G. Diet, H pylori infection and gastric cancer: evidence and controversies. World J Gastroenterol 2007; 13: 2901–2912.

    PubMed  CAS  Google Scholar 

  5. Ladeiras-Lopes R, Pereira AK, Nogueira A, et al. Smoking and gastric cancer: systematic review and meta-analysis of cohort studies. Cancer Causes Control 2008; 19: 689–701.

    Article  PubMed  Google Scholar 

  6. Nishino Y, Inoue M, Tsuji I, et al. Tobacco smoking and gastric cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Jpn J Clin Oncol 2006; 36: 800–807.

    Article  PubMed  Google Scholar 

  7. Yang GH, Ma JM, Liu N, et al. Smoking and passive smoking in Chinese, 2002. Zhonghua Liuxingbingxue Zazhi 2005; 26: 77–83.

    PubMed  CAS  Google Scholar 

  8. Egger M, Smith GD, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ 1995; 315: 629–634.

    Google Scholar 

  9. Greenland S, Longnecker MP. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol 1992; 135: 1301–1309.

    PubMed  CAS  Google Scholar 

  10. Sun XW, Jiang JS, Dai XD, et al. The risk factors of stomach cancer: a case-control study. Zhongguo Manxingbing Yu Fangyu Kongzhi 2000; 8:259–261 (Chinese).

    Google Scholar 

  11. Sun XW, Dai XD, Lin YJ, et al. The relationship between gastric cancer and the unhealthy habits and the gastric diseases. Zhongguo Manxingbing Yu Fangyu Kongzhi 1999; 7: 220–221 (Chinese).

    Google Scholar 

  12. Bao PP, Tao MH, Liu DK, et al. A case-control study of smoking, alcohol consumption and stomach cancer. Zhong Liu 2001; 21: 334–338 (Chinese).

    Google Scholar 

  13. Bao PP, Gao LF, Liu DK, et al. A case-control study on risk factors for stomach cancer in urban Shanghai. Zhong Liu 2003; 23: 458–463 (Chinese).

    Google Scholar 

  14. Li L, Han GJ, Liu JS. A case-control study on risk factors for stomach cancer in Chengde. Jibing Jiance 2004; 19: 428–430 (Chinese).

    Google Scholar 

  15. Wang XW, Xin MX, Li L. A case-control study of the risk factors of stomach cancer Incidence. Xiandai Yufang Yixue 2007; 34: 3081–3082 (Chinese).

    Google Scholar 

  16. Zhou LF, Wang GD, Zhou ES, et al. An Etiological study of primary gastric cancer. Zhongguo Gonggong Weisheng Xuebao 1998; 17: 1–3 (Chinese).

    Google Scholar 

  17. Cui L, Yang Y, Yuan JC, et al. A case-control study of the risk factors of stomach cancer incidence of male population of Jiang Yan. Zhongliu Yanjiu Yu Linchuang 2001; 13: 358–359 (Chinese).

    Google Scholar 

  18. Liu XM, Wang QS, Ma J, et al. A case-control study on the risk factors of stomach cancer in Tianjin city. Zhonghua Liuxingbingxue Zazhi 2001; 22: 362–364 (Chinese).

    PubMed  CAS  Google Scholar 

  19. Zhou Y, Zhang JH, Gong YZ, et al. A case-control study on risk factors of gastric cancer. Chenzhou Yixue Gaodeng Zhuanke Xuexiao Xuebao 2001; 3: 149–152 (Chinese).

    Google Scholar 

  20. Liu XM, Wang QS, Ma J, et al. Case-control Study on Risk Factors of Stomach Cancer. Zhongguo Manxingbing Yu Fangyu Kongzhi 2001; 9: 10–11 (Chinese).

    CAS  Google Scholar 

  21. Shen J, Wang RT, Xing HX, et al. Comparison of risk factors for stomach cancer in high and low incidence areas of Yangzhong county, China. Zhongguo Manxingbing Yu Fangyu Kongzhi 2001; 9: 114–116 (Chinese).

    Google Scholar 

  22. Shen XB, Zhang J, Pu YP, et al. Analysis on attributable risk for environmental and genetic risk factors of gastric cancer. Zhongguo Gonggong Weisheng 2005; 21: 1–3(Chinese).

    CAS  Google Scholar 

  23. Zhang Z, Han CL, Che X, et al. Case-control study on risk factors of stomach cancer. Zhongguo Gonggong Weisheng 2005; 21: 7–8 (Chinese).

    Google Scholar 

  24. Lian YS, Zhang J, Shen XB, et al. Analysis on attributable risk for environmental and genetic risk factors of gastric cancer. Shiyong Yu Fangyixue 2006; 13: 1450–1451 (Chinese).

    Google Scholar 

  25. Wei YH, Lv H, Ni JF, et al. Conditional logistic analysis of smoking, alcohol consumption and gastric cancer. Jibing Kongzhi Zazhi 2006; 10: 116–119 (Chinese).

    Google Scholar 

  26. Wang XS, Wu DL, Zhang XF, et al. Case-control study on factors for stomach cancer in Ganyu country. Shiyong Yu Fangyixue 2008; 15: 1443–1444 (Chinese).

    Google Scholar 

  27. He M, Yin ZH, Yuan Y, et al. 1:4 Matched case-control study on risk factors of gastric cancer in Zhuanghe. Xiandai Yu Fangyixue 2008; 35: 2201–2202 (Chinese).

    Google Scholar 

  28. Lu JB, Sun XB, Quan PL, et al. The selected factors with cancers of the esophagus and gastric cardia: a prospective study on high-risk population in Henan. Henan Yixue Yanjiu 1998; 7: 347–349 (Chinese).

    Google Scholar 

  29. Yang JH, Fan ZH. A prospective cohort study of the relationship between tobacco smoking, alcohol, drinking and the mortality of gastric carcinoma. Xiandai Yu Fangyixue 2000; 27: 322–324 (Chinese).

    Google Scholar 

  30. Ji BT, Chow WH, Yang G, et al. The influence of cigarette smoking, alcohol, and green tea consumption on the risk of carcinoma of the cardia and distal stomach in Shanghai, China. Cancer 1996; 77: 2449–2457.

    Article  PubMed  CAS  Google Scholar 

  31. Gao CM, Takezaki T, Ding JH, et al. Protective effect of allium vegetables against both esophageal and stomach cancer:a simultaneous case-referent study of a high-epidemic area in Jiangsu province, China. Jpn. J. Cancer Res 1999; 90: 614–621.

    CAS  Google Scholar 

  32. Chen MJ, Chiou YY, Wu DC, et al. Lifestyle habits and gastric cancer in a hospital-based case-control study in Taiwan. Am J Gastroenterol 2000; 95: 3242–3249.

    Article  PubMed  CAS  Google Scholar 

  33. Takezaki T, Gao CM, Wu JZ, et al. Dietary protective and risk factors for esophageal and stomach cancers in a low-epidemic area for stomach cancer in Jiangsu province, China: comparison with those in a high-epidemic area. Jpn J Cancer Res 2001; 92: 1157–1165.

    PubMed  CAS  Google Scholar 

  34. Gao CM, Takezaki T, Wu JZ, et al. Glutathione-S-transferases M1 (GSTM1) and GSTT1 genotype, smoking, consumption of alcohol and tea and risk of esophageal and stomach cancers: a case-control study of a high-incidence area in Jiangsu Province, China. Cancer Lett 2002; 188: 95–102.

    Article  PubMed  CAS  Google Scholar 

  35. Cai L, Zheng ZL, Zhang ZF. Risk factors for the gastric cardia cancer: a case-control study in Fujian Province. World J Gastroenterol 2003; 9: 214–218.

    PubMed  Google Scholar 

  36. Chen MJ, Wu DC, Ko YC, et al. Personal history and family history as a predictor of gastric cardiac adenocarcinoma risk: a case-control study in Taiwan. American Journal of Gastroenterology 2004; 99: 1250–1257.

    Article  PubMed  Google Scholar 

  37. Guo W, Blot WJ, Li JY, et al. A nested case-control study of oesophageal and stomach cancers in the Linxian nutrition intervention trial. Int J Epidemiol 1994; 23: 444–450.

    Article  PubMed  CAS  Google Scholar 

  38. Yuan JM, Ross RK, Wang XL, et al. Morbidity and mortality in relation to cigarette smoking in Shanghai, China. A prospective male cohort study. JAMA 1996; 275: 1646–1650.

    Article  PubMed  CAS  Google Scholar 

  39. Liaw KM, Chen CJ. Mortality attributable to cigarette smoking in Taiwan: a 12-year follow-up study. Tob Control 1998; 7: 141–148.

    Article  PubMed  CAS  Google Scholar 

  40. Sai YH, Tai HL, Chao QJ, et al. Smoking, occupational exposure and mortality in workers in Guangzhou, China. Elsevier 2002; 12: 370–377.

    Google Scholar 

  41. Wen CP, Tsai SP, Chen CJ, et al. The mortality risks of smokers in Taiwan: Part I: cause-specific mortality. Prev Med 2004; 39: 528–535.

    Article  PubMed  Google Scholar 

  42. Gina D.T, Sun XD, Christian C.A, et al. Prospective study of risk factors for esophageal and gastric cancers in the Linxian general population trial cohort in China. Int J Cancer 2005; 113: 456–463.

    Article  Google Scholar 

  43. Liu YX, Wang JZ. Meta-analysis of the relationship between smoking and stomach cancer. Zhongguo Yixue Kexue Yuanxuebao 2002; 24: 559–563 (Chinese).

    Google Scholar 

  44. Zhou XB, Zhang J, Zhang CY. Meta analysis of association between life habits and stomach cancer in Chinese people. Zhongguo Linchuang Kangfu 2006; 10: 10–12 (Chinese).

    Google Scholar 

  45. Tayler R, Piper DW. The carcinogenic effect of cigarette smoke. The effect of cigarette smoke on human gastric mucosal cells in organ culture. Cancer 1977; 39: 2520–2523.

    Article  PubMed  CAS  Google Scholar 

  46. Mirvish SS. Role of N-nitroso compounds (NOC) and N-nitrosation in etiology of gastric, esophageal, nasopharyngeal and bladder cancer and contribution to cancer of known exposures to NOC. Cancer Lett 1995; 93: 17–48.

    Article  PubMed  CAS  Google Scholar 

  47. Kneller RW, You WC, Chang YS, et al. Cigarette smoking and other risk factors for progression of precancerous stomach lesions. J Natl Cancer Inst 1992; 84: 1261–1266.

    Article  PubMed  CAS  Google Scholar 

  48. Stemmermann GN, Nomura AM, Chyou PH, et al. Impact of diet and smoking on risk of developing intestinal metaplasia of the stomach. Dig Dis Sci 1990; 35: 433–438.

    Article  PubMed  CAS  Google Scholar 

  49. Dyke GW, Craven JL, Hall R, et al. Smoking-related DNA adducts in human gastric cancers. Int J Cancer 1992; 52: 847–850.

    Article  PubMed  CAS  Google Scholar 

  50. Orsini N, Bellocco R, Greenland S. Generalized least squares for trend estimation of summarized dose-response data. Stata J 2006; 6: 40–45.

    Google Scholar 

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Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, Radiation Medicine and Public Health School of Soochow University, Suzhou, 215123, Jiangsu Province, China

    Na Liu, Yueping Shen, Tianfeng He & Yinmei Liu

  2. Department of Nutrition and Food Hygiene, Radiation Medicine and Public Health School of Soochow University, Suzhou, 215123, Jiangsu Province, China

    Liqiang Qin

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  1. Na Liu
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  2. Yueping Shen
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  3. Liqiang Qin
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  4. Tianfeng He
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  5. Yinmei Liu
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Corresponding author

Correspondence to Yueping Shen.

Additional information

This work was supported by a grant from the National Natural Science Foundation of China (No.30872176).

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Liu, N., Shen, Y., Qin, L. et al. Meta-analysis of smoking and the risk of gastric cancer among the Chinese population. Clin. Oncol. Cancer Res. 6, 296–302 (2009). https://doi.org/10.1007/s11805-009-0296-3

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  • DOI: https://doi.org/10.1007/s11805-009-0296-3

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