2018
DOI: 10.1097/cej.0000000000000290
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Cigarette smoking and gastric cancer in the Stomach Cancer Pooling (StoP) Project

Abstract: Tobacco smoking is a known cause of gastric cancer, but several aspects of the association remain imprecisely quantified. We examined the relation between cigarette smoking and the risk of gastric cancer using a uniquely large dataset of 23 epidemiological studies within the 'Stomach cancer Pooling (StoP) Project' , including 10 290 cases and 26 145 controls. We estimated summary odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) by pooling study-specific ORs using random-effects models. Co… Show more

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Cited by 160 publications
(109 citation statements)
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References 47 publications
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“…The disparities in GC risk among socioeconomic classes have been attributed to the uneven distribution of lifestyle risk factors for GC that favors people in the highest SEP, with differences in smoking, alcohol drinking and dietary habits being thought to play a major role. However, when we adjusted for these risk factors, the magnitude of the association remained strong, suggesting that the reduced risk of GC associated with a high SEP operates through more complex pathways than those related to modifiable risk factors.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The disparities in GC risk among socioeconomic classes have been attributed to the uneven distribution of lifestyle risk factors for GC that favors people in the highest SEP, with differences in smoking, alcohol drinking and dietary habits being thought to play a major role. However, when we adjusted for these risk factors, the magnitude of the association remained strong, suggesting that the reduced risk of GC associated with a high SEP operates through more complex pathways than those related to modifiable risk factors.…”
Section: Discussionmentioning
confidence: 99%
“…42 A strong inverse association emerged also in a recent large longitudinal Italian census-based study reporting reduced mortality among highly educated individuals in both sexes, with standardized mortality ratio of 0.41 in men and 0.50 in women for the highest compared to the lowest level of education. 8 The disparities in GC risk among socioeconomic classes have been attributed to the uneven distribution of lifestyle risk factors for GC that favors people in the highest SEP, with differences in smoking, 44 alcohol drinking 45 and dietary habits 46 being thought to play a major role. However, when we adjusted for these risk factors, the magnitude of the association remained strong, suggesting that the reduced risk of GC associated with a high SEP operates through more complex pathways than those related to modifiable risk factors.…”
Section: Discussionmentioning
confidence: 99%
“…The increased risk seen with smoking and stomach cancer in this study is higher than that reported in a meta-analysis of cohort studies that compared former vs never smokers in males RR 1.42; 95%CI 1.21–1.67) [27] and a meta-analysis of 10,290 cases and 26,145 controls which reported a pooled OR of 1.12 (95%CI 0.99–1.27) for former and OR 1.25 (95%CI 1.11–1.40) for current smokers compared to never smokers [28]. We assessed the impact of SEP as a confounder on our results (S1 Table) which show a reduced OR in ex-smokers from 2.26 (95%CI 1.44–3.54) to 1.98 (95%CI 1.25–3.14) and in current smokers, from OR 1.46 (95% CI 0.86–2.48) to OR 1.15 (95%CI 0.67–1.99).…”
Section: Discussionmentioning
confidence: 99%
“…Positive associations between tobacco smoking and stomach cancer have been reported [2728]. Māori have had some of the highest smoking rates in the world and begin smoking at an earlier age than other populations [29–30].…”
Section: Introductionmentioning
confidence: 99%
“…Our study is based on the second data release of the StoP project consortium (http://www.stop-project.org/), which included 31 case–control studies of gastric cancer conducted worldwide. Detailed information on the aims and methods of the StoP project has been given elsewhere . Participating studies were involved through personal contacts of participating investigators.…”
Section: Methodsmentioning
confidence: 99%