U‐shaped Effect of Drinking and Linear Effect of Smoking on Risk for Stomach Cancer in Japan

Kikuchi, Shogo; Nakajima, Toshifusa; Kobayashi, Osamu; Yamazaki, Tatsuo; Kikuichi, Masahiro; Mori, Kiyoshi; Oura, Shinsuke; Watanabe, Hideaki; Nagawa, Hirokazu; Otani, Reiji; Okamoto, Naoyuki; Kurosawa, Michiko; Anzai, Haruyuki; Konishi, Toshiro; Futagawa, Shunji; Mizobuchi, Noboru; Kobori, Oichiro; Kaise, R; Inaba, Yutaka; Wada, Osamu

doi:10.1111/j.1349-7006.2002.tb02470.x

Cited by 26 publications

(35 citation statements)

References 31 publications

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“…11,18,19) Few studies have reported the sexspecific risk of stomach cancer. 23,25) The present results provide evidence indicating that Japanese male smokers are at an elevated risk of stomach cancer. Curiously, in females, on the other hand, smoking history was inversely associated with stomach cancer risk.…”

Section: Discussionsupporting

confidence: 59%

“…Otherwise, distributions of anatomical and histologic subtype among female stomach cancers may be related to the inverse association with cigarette smoking among females, since some previous studies have indicated that the association with cigarette smoking may differ in this way. 23,25) We could not clarify risk patterns by subtype due to incomplete data for subtype in our hospital cancer registry. Therefore, detailed analyses by anatomical and histologic subtype are needed in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…Many hospital-based epidemiological studies have been conducted in Japan to clarify the association between cigarette smoking and cancer risk. 9,11,[16][17][18][19][20][21][22][23][24][25] Compared with these reported studies, ours is unique in simultaneously examining the effect of cigarette smoking on the risks at plural leading cancer sites. However, in hospital-based casecontrol studies, methodological problems are likely to arise in selecting cases and controls.…”

Section: Discussionmentioning

confidence: 99%

“…In stomach cancer, the effect of Helicobacter pylori infection should also be considered. 25) In the present study, we also focused on the patient referral pattern and conducted an additional analysis. This analysis suggested that the risk for cigarette smoking might be modified by the referral pattern (screened and not screened).…”

Section: Discussionmentioning

confidence: 99%

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Associations between cigarette smoking and the risk of four leading cancers in Miyagi Prefecture, Japan: A multi‐site case‐control study

Minami

Tateno

2003

Cancer Science

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Although cigarette smoking is a well-known risk factor of lung cancer, associations of cigarette smoking with the risk of other sites have not been fully elucidated in Japan. To simultaneously evaluate the associations of cigarette smoking with the risks of cancers of the stomach, lung, colon, and rectum, which have been the leading cancer sites in recent years in Miyagi Prefecture, Japan, we conducted a hospital-based case-control study. Study subjects consisted of 614 stomach, 515 lung, 324 colon, and 164 rectal cancer cases and 2444 hospital controls admitted to a single hospital in Miyagi Prefecture from 1997 to 2001. Information on smoking habit and other lifestyle factors was collected using a self-administered questionnaire. Distributions of referral base among cases and controls were also investigated. For each site, odds ratios (ORs) and 95% confidence intervals (95% CIs) for smoking habit were estimated with adjustment for age, year of survey, history of alcohol drinking, family history of index cancer, and occupational history, respectively, using an unconditional logistic regression model. Cigarette smoking (ever vs. never) was associated with an increased risk of stomach (OR = = = =1.62; 95% CI 1.20-2.19) and lung (OR = = = =3.82; 95% CI 2.49-5.86) cancer among males and lung cancer among females (OR = = = =2.02; 95% CI 1.28-3.18). For female stomach cancer, the association with cigarette smoking was uncertain (OR = = = =0.65, P = = = =0.1533). For rectal cancer, a significant increased risk was observed in both-sex-combined analysis. There was no association between cigarette smoking and the risk of colon cancer. Detailed analysis showed that the association of cigarette smoking with cancer risk might be modified by the patient referral pattern, i.e., screened or not screened. The present results indicate that the association of cigarette smoking with cancer risk may differ among sites and sexes. In terms of the population attributable risk, a large proportion of leading cancers in males appears to be related to cigarette smoking. (Cancer Sci 2003; 94: 540-547) ver the past several decades, the trends in cancer incidence have been changing in Japan. Stomach cancer incidence, which is still highest in males, has been gradually decreasing, while lung, colon, rectal and breast cancer incidences have been increasing.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Associations between cigarette smoking and the risk of four leading cancers in Miyagi Prefecture, Japan: A multi‐site case‐control study

Minami

Tateno

2003

Cancer Science

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“…For the risk grouping of patients with welldifferentiated gastric adenocarcinoma (at onset), the presence or absence of H. pylori infection (5,6), smoking history (18,19), history of alcohol consumption (19) and serum pepsinogen levels (4,6) have been reported as relevant. However, these factors have not been demonstrated to be useful for risk grouping poorly-differentiated gastric adenocarcinoma patients.…”

Section: Discussionmentioning

confidence: 99%

Single nucleotide polymorphism typing of the human toll-like receptor 4 gene at the 2-kb upstream region of the 5' untranslated region: New enclosure strategy for the risk grouping of poorly-differentiated gastric adenocarcinoma patients

Ohara

Kanoh²,

Tani³

et al. 2008

Mol Med Rep

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Abstract. To date, no enclosure method for risk grouping patients with poorly-differentiated gastric adenocarcinoma has been identified. We examined the relationship between mutations in toll-like receptor 4 (TLR4) and patients with poorly-differentiated gastric adenocarcinoma. Genomic DNA was extracted from the peripheral blood of 38 patients, 20 with well-differentiated and 18 with poorly-differentiated gastric cancer, from 25 patients with colorectal cancer and from 10 healthy volunteers. The polymorphism of TLR4 up to the 2-kb upstream region of the 5' untranslated region (UTR) was analyzed. The results revealed the presence of single nucleotide polymorphisms (SNPs) only among patients with poorlydifferentiated gastric adenocarcinoma. SNPs were found at 3 sites: -2081, -2026 and -1601 in 12, 15 and 15 of the 18 cases of poorly-differentiated gastric adenocarcinoma, respectively. The results of the determination of a consensus among the base sequences of the core promoter, basal promoter and upstream promoter elements reveal that the variant sites were present in the TLR4 mRNA promoter region, suggesting that they were biologically significant variations. Polymorphism analysis of the upstream region of the 5' UTR of TLR4 may be a useful new enclosure strategy for the risk grouping of poorly-differentiated gastric adenocarcinoma patients. IntroductionWith the recent development of new techniques, such as polymorphism analysis of the genome and genes, screening methods for gastrointestinal tract cancer are changing (1-3). Significant enclosure methods for risk grouping patients with well-differentiated gastric adenocarcinoma have been developed, as represented by the Helicobacter pylori (H. pylori) and pepsinogen methods (4-6). However, to date no enclosure method for risk grouping patients with poorly-differentiated gastric adenocarcinoma at the time of diagnosis of gastric cancer has been established. Structurally, human genes consist of exons and introns, or the so-called gene-coding region and untranslated region (UTR). Upstream of the 5' UTR terminal side is the promoter region, which is the binding site of RNA polymerase to the UTR of DNA. The binding of RNA polymerase to this promoter initiates transcription into RNA. Thus, the upstream region of the 5' UTR terminal side is a biologically important region involved in gene expression and regulation.Toll-like receptors (TLRs) are signal transduction molecules involved in the conversion of natural immunity to acquired immunity (7,8). Among them, toll-like receptor 4 (TLR4) recognizes lipopolysaccharides such as H. pylori as pathogen-associated molecular patterns, and is closely involved in the formation of mucosal lesions.In this study, in order to examine the genetic background of patients with gastrointestinal tract carcinoma and particularly those with poorly-differentiated gastric adenocarcinoma, polymorphism analysis of the TRL4 gene at the 2-kb upstream region of the 5' UTR was performed in patients with gastric cancer or colorectal cancer and in heal...

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Cigarette smoking and the risk of gastric cancer: A pooled analysis of two prospective studies in Japan

Koizumi

Tsubono

Nakaya

et al. 2004

Intl Journal of Cancer

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To examine the association between cigarette smoking and the risk of gastric cancer, we conducted a pooled analysis of 2 population-based prospective cohort studies in rural northern Japan. Cohort 1 included 9,980 men (>40 years old) and Cohort 2 included 19,412 men (40 -64 years old). The subjects completed a self-administered questionnaire on cigarette smoking and other health habits. We identified 228 cases of gastric cancer among Cohort 1 subjects (9 years of follow-up with 74,073 person-years) and 223 among Cohort 2 subjects (7 years of follow-up with 141,675 person-years). From each cohort, we computed the relative risk (RR) and 95% confidence interval (CI) of gastric cancer associated with smoking using a Cox regression analysis and pooled these estimates to obtain summary measures. The pooled multivariate RRs (95% CIs) for current smokers and past smokers compared to subjects who had never smoked were 1. An increased risk of gastric cancer associated with tobacco smoking has long been controversial. 1 Although the International Agency for Research on Cancer Working Group concluded in 2002 that there was "sufficient" evidence of causality, 2 it remains to be clarified if the effects of smoking differ by anatomic subsite or histologic subtype of gastric cancer. Furthermore, the majority of available evidence on smoking and gastric cancer are based on case-control studies 3-75 that are susceptible to selection and recall biases, and most prospective studies have methodologic limitations including the use of mortality rather than incidence as an endpoint, 76,78,79,81,82,84,85,[87][88][89] the use of a relatively small number (Ͻ300) of gastric cancer cases 77,79 -83,85-87,89 or no adjustment for dietary variables as potential confounders. 78 -89 To further examine the association between cigarette smoking and the risk of gastric cancer, we conducted a pooled analysis of 2 population-based prospective cohort studies in rural northern Japan, a high-risk area for gastric cancer. Our study involved 451 incidence cases of gastric cancer, and we adjusted for various potential confounders, including dietary variables. We also examined the association according to the anatomic subsite and histologic subtype of gastric cancer. MATERIAL AND METHODS Study cohortsThe study designs for the 2 cohort studies have been described in detail elsewhere. 90 -92 Briefly, Cohort 1 was started in January 1984, when we delivered a self-administered questionnaire to 33,453 men and women (40 years of age or older) in 3 municipalities of Miyagi Prefecture. Usable questionnaires were returned from 31,345 subjects (93.7%). For Cohort 2, we delivered a self-administered questionnaire from June to August 1990 to 51,921 men and women (40 -64 years of age) in 14 municipalities of the Prefecture. Usable questionnaires were returned from 47,605 subjects (91.7%). Study protocols for the 2 cohorts were approved by the institutional review board of the Tohoku University Graduate School of Medicine. We considered the return of self-administered...

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U‐shaped Effect of Drinking and Linear Effect of Smoking on Risk for Stomach Cancer in Japan

Cited by 26 publications

References 31 publications

Associations between cigarette smoking and the risk of four leading cancers in Miyagi Prefecture, Japan: A multi‐site case‐control study

Associations between cigarette smoking and the risk of four leading cancers in Miyagi Prefecture, Japan: A multi‐site case‐control study

Single nucleotide polymorphism typing of the human toll-like receptor 4 gene at the 2-kb upstream region of the 5' untranslated region: New enclosure strategy for the risk grouping of poorly-differentiated gastric adenocarcinoma patients

Cigarette smoking and the risk of gastric cancer: A pooled analysis of two prospective studies in Japan

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