Collatuzzo Giulia, Pelucchi Claudio, Negri Eva, Kogevinas Manolis, Huerta José María, Vioque Jesus, de la Hera Manoli García, Tsugane Shoichiro, Shigueaki Hamada Gerson, Hidaka Akihisa, Zhang Zuo-Feng, Camargo M Constanza, Curado Maria Paula, Lunet Nuno, La Vecchia Carlo, Boffetta Paolo
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", University of Milan, 20133 Milan, Italy.
Cancers (Basel). 2023 Aug 29;15(17):4319. doi: 10.3390/cancers15174319.
The association between sleep and stress and cancer is underinvestigated. We evaluated these factors in association with gastric cancer (GC). Five case-control studies from the Stomach Cancer Pooling (StoP) Project were included. We calculated the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) for sleep duration and stress level in association with GC through multiple logistic regression models adjusted for several lifestyle factors. The analysis included 1293 cases and 4439 controls, 215 cardia and 919 noncardia GC, and 353 diffuse and 619 intestinal types. Sleep duration of ≥9 h was associated with GC (OR =1.57, 95% CI = 1.23-2.00) compared to 8 h. This was confirmed when stratifying by subsite (noncardia OR = 1.59, 95% CI = 1.22-2.08, and cardia OR = 1.63, 95% CI = 0.97-2.72) and histological type (diffuse OR = 1.65, 95% CI = 1.14-2.40 and intestinal OR = 1.24, 95% CI = 0.91-1.67). Stress was associated with GC (OR = 1.33, 95% CI = 1.18-1.50, continuous). This relationship was selectively related to noncardia GC (OR = 1.28, 95% 1.12-1.46, continuous). The risk of diffuse (OR = 1.32, 95% CI = 1.11-1.58) and intestinal type (OR = 1.23, 95% CI = 1.07-1.42) were higher when stress was reported. Results for the association between increasing level of stress and GC were heterogeneous by smoking and socioeconomic status ( for heterogeneity = 0.02 and <0.001, respectively). In conclusion, long sleep duration (≥9 h) was associated with GC and its subtype categories. Stress linearly increased the risk of GC and was related to noncardia GC.
睡眠、压力与癌症之间的关联研究不足。我们评估了这些因素与胃癌（GC）的关系。纳入了胃癌合并（StoP）项目的五项病例对照研究。通过针对多种生活方式因素进行调整的多元逻辑回归模型，我们计算了与GC相关的睡眠时长和压力水平的比值比（OR）及相应的95%置信区间（CI）。分析包括1293例病例和4439例对照，215例贲门癌和919例非贲门癌GC，以及353例弥漫型和619例肠型。与8小时相比，睡眠时长≥9小时与GC相关（OR = 1.57，95% CI = 1.23 - 2.00）。按亚部位分层（非贲门癌OR = 1.59，95% CI = 1.22 - 2.08，贲门癌OR = 1.63，95% CI = 0.97 - 2.72）和组织学类型分层（弥漫型OR = 1.65，95% CI = 1.14 - 2.40，肠型OR = 1.24，95% CI = 0.91 - 1.67）时，这一结果得到证实。压力与GC相关（OR = 1.33，95% CI = 1.18 - 1.50，连续变量）。这种关系与非贲门癌GC选择性相关（OR = 1.28，95% 1.12 - 1.46，连续变量）。报告有压力时，弥漫型（OR = 1.32，95% CI = 1.11 - 1.58）和肠型（OR = 1.23，95% CI = 1.07 - 1.42）的风险更高。压力水平升高与GC之间的关联结果在吸烟和社会经济地位方面存在异质性（异质性分别为0.02和<0.001）。总之，长睡眠时长（≥9小时）与GC及其亚型相关。压力会线性增加GC的风险，且与非贲门癌GC有关。
