Department of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110 Ioannina, Greece.
Nutrients. 2022 Apr 23;14(9):1764. doi: 10.3390/nu14091764.
Several dietary exposures have been associated with gastric cancer (GC), but the associations are often heterogenous and may be afflicted by inherent biases. In the context of an Umbrella Review (UR), we provide an overview and a critical evaluation of the strength and quality, and evidence classification of the associations of diet-related exposures in relation to the risk of GC. We searched PubMed and Scopus for eligible meta-analyses of observational studies published in English from inception to 12 December 2021, and for any identified association, we applied robust epidemiological validity evaluation criteria and individual study quality assessment using AMSTAR. We screened 3846 titles/abstracts and assessed 501 full articles for eligibility, of which 49 were included in the analysis, investigating 147 unique exposures in relation to GC, cardia (GCC) or non-cardia (GNCC) cancer. Supported by suggestive evidence, positive associations were found comparing the highest vs. lowest categories for: heavy (>42 g/day) alcohol consumption (Relative Risk (RR) = 1.42, 95% Confidence Interval (CI): 1.20−1.67), salted fish consumption (RR = 1.56, 95% CI:1.30−1.87) and waist circumference (RR = 1.48, 95% CI:1.24−1.78) and an inverse association for the healthy lifestyle index (RR = 0.60, 95% CI:0.48−0.74) in relation to GC. Additionally, a positive association was found comparing obese individuals (Body Mass Index (BMI) ≥ 30) to normal-weight individuals (BMI: 18.5−25) (RR = 1.82, 95% CI:1.32−2.49) in relation to GCC. Most of the meta-analyses were of medium-to-high quality (median items: 7.0, interquartile range: 6−9). Maintaining a normal body weight and adopting healthy dietary choices, in particular, limiting the consumption of salt-preserved foods and alcohol, can reduce the risk of gastric cancer.
一些饮食因素与胃癌(GC)有关,但这些关联往往存在异质性,并且可能受到固有偏见的影响。在伞式评价(UR)的背景下,我们提供了与 GC 风险相关的饮食相关暴露与胃癌风险关联的概述和批判性评估,包括强度和质量,以及证据分类。我们在 PubMed 和 Scopus 中搜索了自成立至 2021 年 12 月 12 日发表的英文观察性研究的合格荟萃分析,并对任何已确定的关联,我们应用了稳健的流行病学有效性评估标准和个体研究质量评估使用 AMSTAR。我们筛选了 3846 个标题/摘要,并评估了 501 篇全文文章的合格性,其中 49 篇被纳入分析,研究了 147 种与 GC、贲门(GCC)或非贲门(GNCC)癌症相关的独特暴露。有充分证据表明,与最低类别相比,最高类别与以下因素呈正相关:大量(>42 克/天)饮酒(相对风险(RR)=1.42,95%置信区间(CI):1.20-1.67)、咸鱼摄入(RR=1.56,95% CI:1.30-1.87)和腰围(RR=1.48,95% CI:1.24-1.78)以及健康生活方式指数(RR=0.60,95% CI:0.48-0.74)与 GC 呈负相关。此外,与正常体重个体(BMI:18.5-25)相比,肥胖个体(BMI≥30)与 GCC 呈正相关(RR=1.82,95% CI:1.32-2.49)。大多数荟萃分析的质量为中到高(中位数项目:7.0,四分位距:6-9)。保持正常体重和采用健康的饮食选择,特别是限制盐腌食品和酒精的摄入,可以降低胃癌的风险。
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