Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Risk Factors of Gastric Cancer and Lifestyle Modification for Prevention

  • Kwang-Pil Ko (Clinical Preventive Medicine Center, Seoul National University Bundang Hospital)
  • Received : 2023.10.26
  • Accepted : 2023.12.15
  • Published : 2024.01.01
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Abstract

Gastric cancer has been consistently decreasing worldwide, whereas cardia gastric cancer is on the rise. This indicates that the exposure rates to epidemiological causes are changing. In this study, we aim to review the risk factors for gastric cancer with respect to cardia and non-cardia types. One of the most significant risk factors for gastric cancer is Helicobacter pylori infection. H. pylori infection is known as a risk factor for non-cardia gastric cancer, and there have been results indicating that H. pylori infection is not associated with cardia gastric cancer. However, in the East Asian region, there is epidemiological evidence suggesting that H. pylori infection might be a risk factor for cardia gastric cancer. Smoking and alcohol consumption are known risk factors for gastric cancer, regardless of anatomical location. Obesity is considered a factor in the development of cardia gastric cancer. However, further research is needed to understand the specific relationship with non-cardia gastric cancer. The consumption of high-salt and processed meat is more distinctly associated with noncardia gastric cancer than in cardia gastric cancer. In addition to these factors, exposure to chemicals and radiation are considered risk factors for gastric cancer. Primary prevention of gastric cancer involves eliminating or avoiding risk factors such as H. pylori eradication and adopting a healthy lifestyle, including quitting smoking, reducing alcohol consumption, maintaining a healthy weight, and having a low-salt diet.

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References

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209-249. https://doi.org/10.3322/caac.21660
  2. World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Continuous Update Project Report: Diet, Nutrition, Physical Activity and Stomach Cancer 2016. Revised 2018. London: World Cancer Research Fund International; 2008.
  3. Vitelli-Storelli F, Rubin-Garcia M, Pelucchi C, Benavente Y, Bonzi R, Rota M, et al. Family history and gastric cancer risk: a pooled investigation in the Stomach Cancer Pooling (STOP) Project Consortium. Cancers (Basel) 2021;13:3844.
  4. Han Z, Liu J, Zhang W, Kong Q, Wan M, Lin M, et al. Cardia and non-cardia gastric cancer risk associated with Helicobacter pylori in East Asia and the West: a systematic review, meta-analysis, and estimation of population attributable fraction. Helicobacter 2023;28:e12950.
  5. Cavaleiro-Pinto M, Peleteiro B, Lunet N, Barros H. Helicobacter pylori infection and gastric cardia cancer: systematic review and meta-analysis. Cancer Causes Control 2011;22:375-387. https://doi.org/10.1007/s10552-010-9707-2
  6. Poorolajal J, Moradi L, Mohammadi Y, Cheraghi Z, Gohari-Ensaf F. Risk factors for stomach cancer: a systematic review and meta-analysis. Epidemiol Health 2020;42:e2020004.
  7. Ford AC, Yuan Y, Moayyedi P. Helicobacter pylori eradication therapy to prevent gastric cancer: systematic review and meta-analysis. Gut 2020;69:2113-2121. https://doi.org/10.1136/gutjnl-2020-320839
  8. Ferro A, Morais S, Rota M, Pelucchi C, Bertuccio P, Bonzi R, et al. Tobacco smoking and gastric cancer: meta-analyses of published data versus pooled analyses of individual participant data (StoP Project). Eur J Cancer Prev 2018;27:197-204. https://doi.org/10.1097/CEJ.0000000000000401
  9. Deng W, Jin L, Zhuo H, Vasiliou V, Zhang Y. Alcohol consumption and risk of stomach cancer: a metaanalysis. Chem Biol Interact 2021;336:109365.
  10. Rota M, Pelucchi C, Bertuccio P, Matsuo K, Zhang ZF, Ito H, et al. Alcohol consumption and gastric cancer risk - a pooled analysis within the StoP Project Consortium. Int J Cancer 2017;141:1950-1962. https://doi.org/10.1002/ijc.30891
  11. Azizi N, Zangiabadian M, Seifi G, Davari A, Yekekhani E, Safavi-Naini SA, et al. Gastric cancer risk in association with underweight, overweight, and obesity: a systematic review and meta-analysis. Cancers (Basel) 2023;15:2778.
  12. Morais S, Costa A, Albuquerque G, Araujo N, Pelucchi C, Rabkin CS, et al. Salt intake and gastric cancer: a pooled analysis within the Stomach Cancer Pooling (StoP) Project. Cancer Causes Control 2022;33:779-791. https://doi.org/10.1007/s10552-022-01565-y
  13. Ferro A, Rosato V, Rota M, Costa AR, Morais S, Pelucchi C, et al. Meat intake and risk of gastric cancer in the Stomach Cancer Pooling (StoP) Project. Int J Cancer 2020;147:45-55. https://doi.org/10.1002/ijc.32707
  14. Setia N, Clark JW, Duda DG, Hong TS, Kwak EL, Mullen JT, et al. Familial gastric cancers. Oncologist 2015;20:1365-1377. https://doi.org/10.1634/theoncologist.2015-0205
  15. Boland CR, Yurgelun MB. Historical perspective on familial gastric cancer. Cell Mol Gastroenterol Hepatol 2017;3:192-200. https://doi.org/10.1016/j.jcmgh.2016.12.003
  16. Pinheiro H, Oliveira C, Seruca R, Carneiro F. Hereditary diffuse gastric cancer - pathophysiology and clinical management. Best Pract Res Clin Gastroenterol 2014;28:1055-1068. https://doi.org/10.1016/j.bpg.2014.09.007
  17. International Agency for Research on Cancer. IARC Monographs - 100B: Helicobacter pylori. Lyon: International Agency for Research on Cancer; 2012.
  18. Wang F, Meng W, Wang B, Qiao L. Helicobacter pylori-induced gastric inflammation and gastric cancer. Cancer Lett 2014;345:196-202. https://doi.org/10.1016/j.canlet.2013.08.016
  19. Salvatori S, Marafini I, Laudisi F, Monteleone G, Stolfi C. Helicobacter pylori and Gastric Cancer: Pathogenetic Mechanisms. Int J Mol Sci 2023;24:2895.
  20. Zamani M, Ebrahimtabar F, Zamani V, Miller WH, Alizadeh-Navaei R, Shokri-Shirvani J, et al. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther 2018;47:868-876. https://doi.org/10.1111/apt.14561
  21. Peek RM Jr, Blaser MJ. Helicobacter pylori and gastrointestinal tract adenocarcinomas. Nat Rev Cancer 2002;2:28-37. https://doi.org/10.1038/nrc703
  22. El Hafa F, Wang T, Ndifor VM, Jin G. Association between Helicobacter pylori antibodies determined by multiplex serology and gastric cancer risk: A meta-analysis. Helicobacter 2022;27:e12881.
  23. Cai H, Ye F, Michel A, Murphy G, Sasazuki S, Taylor PR, et al. Helicobacter pylori blood biomarker for gastric cancer risk in East Asia. Int J Epidemiol 2016;45:774-781. https://doi.org/10.1093/ije/dyw078
  24. Mukaisho K, Nakayama T, Hagiwara T, Hattori T, Sugihara H. Two distinct etiologies of gastric cardia adenocarcinoma: interactions among pH, Helicobacter pylori, and bile acids. Front Microbiol 2015;6:412.
  25. Naseem M, Barzi A, Brezden-Masley C, Puccini A, Berger MD, Tokunaga R, et al. Outlooks on EpsteinBarr virus associated gastric cancer. Cancer Treat Rev 2018;66:15-22. https://doi.org/10.1016/j.ctrv.2018.03.006
  26. Mirvish SS. Role of N-nitroso compounds (NOC) and N-nitrosation in etiology of gastric, esophageal, nasopharyngeal and bladder cancer and contribution to cancer of known exposures to NOC. Cancer Lett 1995;93:17-48. https://doi.org/10.1016/0304-3835(95)03786-V
  27. Nishino Y, Inoue M, Tsuji I, Wakai K, Nagata C, Mizoue T, et al. Tobacco smoking and gastric cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population. Jpn J Clin Oncol 2006;36:800-807. https://doi.org/10.1093/jjco/hyl112
  28. Gaddy JA, Radin JN, Loh JT, Zhang F, Washington MK, Peek RM Jr, et al. High dietary salt intake exacerbates Helicobacter pylori-induced gastric carcinogenesis. Infect Immun 2013;81:2258-2267. https://doi.org/10.1128/IAI.01271-12
  29. Jagerstad M, Skog K. Genotoxicity of heat-processed foods. Mutat Res 2005;574:156-172. https://doi.org/10.1016/j.mrfmmm.2005.01.030
  30. Yoo JY, Cho HJ, Moon S, Choi J, Lee S, Ahn C, et al. Pickled vegetable and salted fish intake and the risk of gastric cancer: two prospective cohort studies and a meta-analysis. Cancers (Basel) 2020;12:996.
  31. Naemi Kermanshahi M, Safaei E, Tutunchi H, Naghshi S, Mobarak S, Asadi M, et al. Fruit and vegetable intake in relation to gastric cancer risk: a comprehensive and updated systematic review and dose-response meta-analysis of cohort studies. Front Nutr 2023;10:973171.
  32. Van Hecke T, Vossen E, Hemeryck LY, Vanden Bussche J, Vanhaecke L, De Smet S. Increased oxidative and nitrosative reactions during digestion could contribute to the association between well-done red meat consumption and colorectal cancer. Food Chem 2015;187:29-36. https://doi.org/10.1016/j.foodchem.2015.04.029
  33. Lin XJ, Wang CP, Liu XD, Yan KK, Li S, Bao HH, et al. Body mass index and risk of gastric cancer: a meta-analysis. Jpn J Clin Oncol 2014;44:783-791. https://doi.org/10.1093/jjco/hyu082
  34. Chang CJ, Tu YK, Chen PC, Yang HY. Talc exposure and risk of stomach cancer: systematic review and meta-analysis of occupational cohort studies. J Formos Med Assoc 2020;119:781-792. https://doi.org/10.1016/j.jfma.2018.07.015
  35. Fortunato L, Rushton L. Stomach cancer and occupational exposure to asbestos: a meta-analysis of occupational cohort studies. Br J Cancer 2015;112:1805-1815. https://doi.org/10.1038/bjc.2014.599
  36. Lee W, Ahn YS, Lee S, Song BM, Hong S, Yoon JH. Occupational exposure to crystalline silica and gastric cancer: a systematic review and meta-analysis. Occup Environ Med 2016;73:794-801. https://doi.org/10.1136/oemed-2016-103552
  37. Brenner AV, Preston DL, Sakata R, Cologne J, Sugiyama H, Utada M, et al. Comparison of all solid cancer mortality and incidence dose-response in the life span study of atomic bomb survivors, 1958-2009. Radiat Res 2022;197:491-508. https://doi.org/10.1667/RADE-21-00059.1
  38. Henderson TO, Oeffinger KC, Whitton J, Leisenring W, Neglia J, Meadows A, et al. Secondary gastrointestinal cancer in childhood cancer survivors: a cohort study. Ann Intern Med 2012;156:757-766. https://doi.org/10.7326/0003-4819-156-11-201206050-00002
  39. Sugano K. Effect of Helicobacter pylori eradication on the incidence of gastric cancer: a systematic review and meta-analysis. Gastric Cancer 2019;22:435-445. https://doi.org/10.1007/s10120-018-0876-0
  40. Lee YC, Chiang TH, Chou CK, Tu YK, Liao WC, Wu MS, et al. Association between Helicobacter pylori eradication and gastric cancer incidence: a systematic review and meta-analysis. Gastroenterology 2016;150:1113-1124.e5. https://doi.org/10.1053/j.gastro.2016.01.028
  41. Rock CL, Thomson C, Gansler T, Gapstur SM, McCullough ML, Patel AV, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin 2020;70:245-271. https://doi.org/10.3322/caac.21591
  42. Oh JK, Park E, Kim B, Choi YJ, Yun EH, Lim MK, et al. Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021. Epidemiol Health 2022;44:e2022068.
  43. World Health Organization. WHO Global Report on Sodium Intake Reduction. Geneva: World Health Organization; 2023.