Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Chem Biol Interact. 2021 Feb 25;336:109365. doi: 10.1016/j.cbi.2021.109365. Epub 2021 Jan 4.
Stomach cancer is one of the most common cancers in the world. The relationship between alcohol consumption and the risk of stomach cancer remains unclear. Epidemiology studies investigating this relationship have shown inconsistent findings. A meta-analysis was performed to explore the association between alcohol consumption and increased stomach cancer risk. Eighty-one epidemiology studies, including 68 case-control studies and 13 cohort studies, were included in this study. A significant association was found between alcohol consumption and increased risk of stomach cancer (OR = 1.20, 95% CI 1.12-1.27). To explore the source of the significant heterogeneity (p < 0.05, I = 86%), analysis was stratified by study type (case-control study and cohort study), control type (hospital-based control and population-based control), gender (male, female, and mix), race (White and Asian), region (United States, Sweden, China, Japan), subsite of stomach cancer, and type of alcohol. The stratified analyses found that region and cancer subsite are major sources of the high heterogeneity. The inconsistent results in different regions and different subsites might be related to smoking rates, Helicobacter pylori infection, obesity, and potential genetic susceptibility. The positive association between drinking and increased risk of stomach cancer is consistent in stratified analyses. The dose-response analysis showed a clear trend that a higher daily intake of alcohol is associated with a higher risk of stomach cancer.
胃癌是世界上最常见的癌症之一。饮酒与胃癌风险之间的关系尚不清楚。研究这一关系的流行病学研究结果不一致。进行了荟萃分析以探讨饮酒与胃癌风险增加之间的关联。这项研究纳入了 81 项流行病学研究,包括 68 项病例对照研究和 13 项队列研究。结果发现饮酒与胃癌风险增加之间存在显著关联(OR=1.20,95%CI 1.12-1.27)。为了探讨显著异质性的来源(p<0.05,I=86%),按研究类型(病例对照研究和队列研究)、对照类型(医院对照和人群对照)、性别(男性、女性和混合)、种族(白种人和亚洲人)、地区(美国、瑞典、中国、日本)、胃癌部位和饮酒类型进行分层分析。分层分析发现,地区和癌症部位是高度异质性的主要来源。不同地区和不同部位的不一致结果可能与吸烟率、幽门螺杆菌感染、肥胖和潜在的遗传易感性有关。饮酒与胃癌风险增加之间的正相关在分层分析中是一致的。剂量-反应分析显示出明确的趋势,即较高的每日饮酒量与较高的胃癌风险相关。