“…Certain confounding factors such as diet, lifestyle (consumption of fruits, vegetables, red meat, salt, cigarettes, and alcohol, and physical activity), socioeconomic status, place of residence, race, health insurance, and Helicobacter pylori infection have been shown to play paramount roles in gastric cancer development [ 31 , 32 , 33 , 34 , 35 ]. Conversely, the data available for our ecological analysis were based on population-level information and were insufficient to propose a multilevel analysis.…”