A case‐control study of gastric cancer and diet in Italy

Abstract

A case-control study was conducted in high- and low-risk areas of Italy to evaluate reasons for the striking geographic variation in gastric cancer (GC) mortality within the country. Personal interviews with 1,016 histologically confirmed GC cases and 1,159 population controls of similar age and sex revealed that the patients were more often of lower social class and resident in rural areas and more frequently reported a familial history of gastric (but not other) cancer. After adjusting for these effects, case-control differences were found for several dietary variables, assessed by asking about the usual frequency of consumption of 146 food items and beverages. A significant trend of increasing GC risk was found with increasing consumption of traditional soups, meat, salted/dried fish and a combination of cold cuts and seasoned cheeses. The habit of adding salt and the preference for salty foods were associated with elevated GC risk, while more frequently storing foods in the refrigerator, the availability of a freezer and use of frozen foods lowered risk. Reduced GC risk were associated with increasing intake of raw vegetables, fresh fruit and citrus fruits. Lowered risk was also related to consumption of spices, olive oil and garlic. Neither cigarette smoking nor alcoholic beverage drinking were significantly related to GC risk. The case-control differences tended to be consistent across geographic areas, despite marked regional variations in intake levels of certain foods. The high-risk areas tended to show higher consumption of food associated with elevated risk (traditional soups, cold cuts) and lower consumption of foods associated with reduced risks (raw vegetables, citrus fruits, garlic). Our findings indicate that dietary factors contribute to the regional variation of stomach cancer occurrence in Italy, and offer clues for further etiologic and prevention research.

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“…Duration of refrigerator use or freezer use was not associated with stomach cancer risk in the Netherlands Cohort Study, in contrast with the results of casecontrol studies performed in Europe or the USA, which rather consistently reported a decreased stomach cancer risk with long-term use of a refrigerator [2,5,9,16,18,38,54]. Three of the case-control studies did not find an association [15,44,47] and no other cohort study reported on this association.…”

“…Overall, in the majority of case-control studies, positive associations were observed for (total) salt or sodium intake [2,3,33,34], consumption of salted fish, salted meat, pickles and soup [5,7,16,[34][35][36][37][38][39][40], adding salt to food at dinner [5,9,41], preference of salty foods [4,5,11,40,42]. The relative risks reported ranged from 1.5 to 6.7 for various measures of salt intake [14].…”

“…Salt acts as an irritant that leads to mucosal damage in the stomach, excessive cell replication and it makes the mucosa cells more susceptible to carcinogens from foods [1]. Numerous epidemiological studies have investigated the association between stomach cancer risk and salt or sodium intake (e.g., [2][3][4]), salted foods (e.g., [5][6][7]), salt added during cooking or at table (e.g., [8][9][10]) and preference of salty taste (e.g., [11][12][13]). In many case-control studies a positive association was reported between an indicator of high salt intake and stomach cancer risk, but in nearly all cohort studies no association was observed [14].…”

Tomatoes versus lycopene in oxidative stress and carcinogenesis: conclusions from clinical trials

“…This inverse association was particularly evident for aggressive types of prostate cancer and for men not taking a b-carotene supplement (Gann et al, 1999). Several epidemiologic studies have also reported an inverse association between tomato intake and the risk of gastric cancer (La Vecchia et al, 1987;Buiatti et al, 1989;Hansson et al, 1993). Epidemiological observations also report an inverse association between plasma or tissue lycopene levels and the incidence of CVD.…”

Role of Ca(2+) in diallyl disulfide-induced apoptotic cell death of HCT-15 cells

“…Epidemiological studies show that enhanced garlic consumption is closely related with reduced cancer incidence (Haenszel et al, 1972;Buiatti et al, 1989). Dially disulfide (DADS), an oil-soluble organosulfur compound in processed garlic, inhibited the proliferation of human colon, lung, and skin cancer cells Milner, 1996a, Sundaram andMilner, 1996b).…”