Nutritional Factors and Gastric Cancer in Spain

Abstract

A case-control study on diet and gastric cancer, carried out in selected areas of four regions of Spain (Aragon, Castile, Catalonia, and Galicia) in 1988 and 1989, included 354 cases of histologically confirmed gastric adenocarcinoma and 354 controls matched by age, sex, and area of residence. Cases and controls were selected from 15 hospitals, representing most of the hospital facilities in the study areas. Usual diet was estimated by means of a dietary history questionnaire administered by interview. An increased risk of gastric cancer was observed for high consumption of exogenous nitrosamines (odds ratio = 2.1 for the highest quartile of consumption versus the lowest; p for linear trend = 0.007), nitrites, fat, and cholesterol. However, in a multivariate regression model, the effect of fat and cholesterol disappeared. An inverse association with the risk for gastric cancer was seen for high intake of fiber, vitamin C, folate, carotene, and nitrates. High consumption of vitamin C seemed to neutralize the increased risk related to simultaneous consumption of nitrosamines. For histologic type, the authors found no meaningful differences in the effect of most of the nutrients between intestinal and diffuse cancers. Their findings are consistent with previously reported results about the protective effect of fruit and vegetables and the increased risk associated with foods that are important sources of nitrites and preformed nitrosamines.

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

“…Of the previous studies, all of them case -control, that have considered GC pathology in relation to dietary carotenoids, some have failed to detect any associations or differences by subtype (Boeing et al, 1991;Buiatti et al, 1991), whereas others have shown mixed results (Gonzalez et al, 1994;Harrison et al, 1997;Ekstrom et al, 2000), suggesting that the effects of carotenoids might be similar in both histological subtypes. In the present study, none of the analytes, with the possible exception of a-tocopherol, showed any significant effects by anatomical subsite or histological subtype.…”

“…Several case -control studies have shown strong inverse associations between GC risk and higher consumption of some of these nutrients (Buiatti et al, 1990(Buiatti et al, , 1991Gonzalez et al, 1994;Hansson et al, 1994;Ekstrom et al, 2000). Results from prospective dietary studies are conflicting and show either a strong protection (Zheng et al, 1995) or no clear inverse associations between the dietary intake of carotenoids and GC risk (Ocke et al, 1995;Botterweck et al, 2000b).…”

Intake of nitrate and nitrite and the risk of gastric cancer: a prospective cohort study

“…In most studies a statistically significant inverse association was reported between nitrate intake from foods and gastric cancer risk (Risch et al, 1985;Buiatti et al, 1990;Boeing et al, 1991;Gonzalez et al, 1994;Hansson et al, 1994;La Vecchia et al, 1994), which disappeared after additional adjustment for potential confounders (mainly intake of vitamin C and beta-carotene). In all case-control studies on nitrate and gastric cancer risk, a positive association was reported (Risch et al, 1985;Buiatti et al, 1990;Gonzalez et al, 1994;Hansson et al, 1994;La Vecchia et al, 1994;Pobel et al, 1995) which reduced after adjustment for intake of other nutrients.…”

“…Case-control studies have mainly investigated the association between nitrate or nitrite from foods and gastric cancer risk (Risch et al, 1985;Buiatti et al, 1990;Boeing et al, 1991;Palli et al, 1992;Gonzalez et al, 1994;Hansson et al, 1994;La Vecchia et al, 1994;Pobel et al, 1995). In most studies a statistically significant inverse association was reported between nitrate intake from foods and gastric cancer risk (Risch et al, 1985;Buiatti et al, 1990;Boeing et al, 1991;Gonzalez et al, 1994;Hansson et al, 1994;La Vecchia et al, 1994), which disappeared after additional adjustment for potential confounders (mainly intake of vitamin C and beta-carotene).…”

“…1983: Gilli et al 1984: Beresford. 1985: Risch et al 1985: Buiatti et al 1990: Boein, et al 1991: Leclerc et al 1991: Palli et al 1992: Rademacher et al 1992: Xu et al 1992: Gonzalez et al 1994: Hansson et al 1994: La Vecchia et al 1994: Pobel et al 1995 However. in most of these studies high nitrate consumption via ingested food showed no association with gastric cancer risk or even an inverse association.…”