Trédaniel J, Boffetta P, Buiatti E, Saracci R, Hirsch A
Unit of Environmental Cancer Epidemiology, International Agency for Research on Cancer, Lyon, France.
Int J Cancer. 1997 Aug 7;72(4):565-73. doi: 10.1002/(sici)1097-0215(19970807)72:4<565::aid-ijc3>3.0.co;2-o.
Although declining, gastric cancer (GC) is estimated to be second in frequency worldwide. Major causes appear to be environmental rather than genetic. A relationship has been suggested between tobacco smoking and GC. A number of epidemiological studies have been performed dealing with this question. All the cohort studies showed a significantly increased risk of GC of the order of 1.5-2.5 for cigarette smokers. Evidence from case-control studies is less consistent. We have carried out a meta-analysis on the 40 studies providing a quantitative estimate of the association between GC risk and tobacco smoking. Results suggest a risk of stomach cancer among smokers of the order of 1.5-1.6 as compared to non-smokers. The summary relative risk was higher in men (1.59) than in women (1.11). Several studies examined the dose-response relationship which existed in 4 cohort studies and 6 case-control studies. We estimated the number of GC cases attributable to tobacco smoking occurring worldwide: in total, over 80,000 cases of GC (11% of all estimated cases) may be attributed to tobacco smoking each year. This figure is larger than that estimated for other cancers for which association with tobacco smoking is clearly established, such as pancreatic and renal cancers.
尽管胃癌（GC）的发病率呈下降趋势，但据估计其在全球范围内的发病频率仍位居第二。主要病因似乎是环境因素而非遗传因素。吸烟与胃癌之间的关联已被提出。针对这一问题已开展了多项流行病学研究。所有队列研究均显示，吸烟者患胃癌的风险显著增加，约为1.5至2.5倍。病例对照研究的证据则不太一致。我们对40项研究进行了荟萃分析，以定量评估胃癌风险与吸烟之间的关联。结果表明，与不吸烟者相比，吸烟者患胃癌的风险约为1.5至1.6倍。汇总相对风险在男性（1.59）中高于女性（1.11）。多项研究考察了4项队列研究和6项病例对照研究中存在的剂量反应关系。我们估算了全球范围内归因于吸烟的胃癌病例数：总体而言，每年超过80,000例胃癌病例（占所有估算病例的11%）可能归因于吸烟。这一数字高于其他已明确与吸烟有关联的癌症，如胰腺癌和肾癌的估算数字。
