Risk factors for gastric cancer in Latin America: a meta-analysis

Abstract

Background Latin America has among the highest gastric cancer incidence rates in the world, for reasons that are still unknown. In order to identify region-specific risk factors for gastric cancer, we conducted a meta-analysis summarizing published literature. Methods Searches of PubMed and regional databases for relevant studies published up to December 2011 yielded a total of 29 independent case-control studies. We calculated summary odds ratios (OR) for risk factors reported in at least five studies, including socioeconomic status (education), lifestyle habits (smoking and alcohol use), dietary factors (consumption of fruits, total vegetables, green vegetables, chili pepper, total meat, processed meat, red meat, fish and salt) and host genetic variants (IL1B-511T, IL1B-31C, IL1RN*2, TNFA-308A, TP53 codon 72 Arg and GSTM1 null). Study-specific ORs were extracted and summarized using random-effects models. Results Chili pepper was the only region-specific factor reported in at least five studies. Consistent with multifactorial pathogenesis, smoking, alcohol use, high consumption of red meat or processed meat, excessive salt intake and carriage of IL1RN*2 were each associated with a moderate increase in gastric cancer risk. Conversely, higher levels of education, fruit consumption, and total vegetable consumption were each associated with a moderately decreased risk. The other exposures were not significantly associated. No prospective study data were identified. Conclusion Risk factor associations for gastric cancer in Latin America are based on case-control comparisons that have uncertain reliability, particularly with regard to diet; the specific factors identified and their magnitudes of association are largely similar to those globally recognized. Future studies should emphasize prospective data collection and focus on region-specific exposures that may explain high gastric cancer risk.

Cigarette smoking and gastric cancer in the Stomach Cancer Pooling (StoP) Project

“…Our OR estimates for current cigarette smokers were, if anything, slightly lower than those on the basis of published studies, which found risks ranging between 1.5 and 1.7 (Tredaniel et al, 1997; Ladeiras-Lopes et al, 2008; La Torre et al, 2009;Bonequi et al, 2013), resulting in an estimated worldwide population attributable fraction of 19.5% in men and 3.0% in women (Peleteiro et al, 2015). Publication bias may have led to an overestimation of the risk in the published literature.…”

Etiology and Prevention of Gastric Cancer

“…In Korea, gastric cancer-related mortality was negatively associated with use of refrigerators and intake of fruit but not vegetables [55]. From a meta-analysis of 29 case-control studies conducted in Latin America, fruit and total vegetable consumption were each associated with a moderately reduced risk of gastric cancer [56]. In a case-control study from Italy, among the four major diets, named ‘animal products', ‘vitamins and fiber', ‘vegetable unsaturated fatty acids' and ‘starch-rich', gastric cancer risk was positively associated with the ‘animal products' (OR = 2.13, 95% CI 1.34-3.40, for the highest versus the lowest score quartile) and the ‘starch-rich' dietary pattern (OR = 1.67, 95% CI 1.01-2.77), and negatively associated with ‘vitamins and fiber' (OR = 0.60, 95% CI 1.01-2.77) [57].…”

Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population‐based study

“…In the US, the prevalence of H. pylori infection is approximately 31%, with variable prevalence among diverse racial/ethnic groups: 21% in Whites, 52% in African Americans, and 64% in Mexican Americans 6, 9. Marked differences in H. pylori infection have also been reported among Hispanic individuals from different regions of Central and South America 10, 11, 12. Individuals with low levels of education and low socioeconomic status have reported to have more than 5.5‐ and 6.6‐times higher odds of being infected with H. pylori 13…”