Cigarette smoking and gastric cancer in the Stomach Cancer Pooling (StoP) Project

  • Delphine Praud
    Department of Clinical Sciences and Community Health, University of Milan
  • Matteo Rota
    Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan
  • Claudio Pelucchi
    Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan
  • Paola Bertuccio
    Department of Clinical Sciences and Community Health, University of Milan
  • Tiziana Rosso
    Department of Clinical Sciences and Community Health, University of Milan
  • Carlotta Galeone
    Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan
  • Zuo-Feng Zhang
    Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California
  • Keitaro Matsuo
    Division of Molecular Medicine
  • Hidemi Ito
    Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
  • Jinfu Hu
    Harbin Medical University, Harbin
  • Kenneth C. Johnson
    Department of Epidemiology and Community Health, University of Ottawa, Ottawa, Ontario
  • Guo-Pei Yu
    Medical Informatics Center, Peking University, Peking, China
  • Domenico Palli
    Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence
  • Monica Ferraroni
    Department of Clinical Sciences and Community Health, University of Milan
  • Joshua Muscat
    The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York
  • Nuno Lunet
    EPIUnit – Institute of Public Health, University of Porto (ISPUP)
  • Bárbara Peleteiro
    EPIUnit – Institute of Public Health, University of Porto (ISPUP)
  • Reza Malekzadeh
    Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Weimin Ye
    Department of Medical Epidemiology and Biostatistics
  • Huan Song
    Department of Medical Epidemiology and Biostatistics
  • David Zaridze
    Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
  • Dmitry Maximovitch
    Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
  • Nuria Aragonés
    Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III
  • Gemma Castaño-Vinyals
    CIBER Epidemiología y Salud Pública (CIBERESP)
  • Jesus Vioque
    CIBER Epidemiología y Salud Pública (CIBERESP)
  • Eva M. Navarrete-Muñoz
    CIBER Epidemiología y Salud Pública (CIBERESP)
  • Mohammadreza Pakseresht
    Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada
  • Farhad Pourfarzi
    Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Alicja Wolk
    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • Nicola Orsini
    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • Andrea Bellavia
    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • Niclas Håkansson
    Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • Lina Mu
    Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo
  • Roberta Pastorino
    Section of Hygiene – Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario ‘Agostino Gemelli’
  • Robert C. Kurtz
    Department of Medicine, Memorial Sloan Kettering Cancer Centre
  • Mohammad H. Derakhshan
    Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Areti Lagiou
    Department of Public Health and Community Health, School of Health Professions, Athens Technological Educational Institute
  • Pagona Lagiou
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  • Paolo Boffetta
    The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York
  • Stefania Boccia
    Section of Hygiene – Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario ‘Agostino Gemelli’
  • Eva Negri
    Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Milan
  • Carlo La Vecchia
    Department of Clinical Sciences and Community Health, University of Milan

抄録

<jats:p>Tobacco smoking is a known cause of gastric cancer, but several aspects of the association remain imprecisely quantified. We examined the relation between cigarette smoking and the risk of gastric cancer using a uniquely large dataset of 23 epidemiological studies within the ‘Stomach cancer Pooling (StoP) Project’, including 10 290 cases and 26 145 controls. We estimated summary odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) by pooling study-specific ORs using random-effects models. Compared with never smokers, the ORs were 1.20 (95% CI: 1.09–1.32) for ever, 1.12 (95% CI: 0.99–1.27) for former, and 1.25 (95% CI: 1.11–1.40) for current cigarette smokers. Among current smokers, the risk increased with number of cigarettes per day to reach an OR of 1.32 (95% CI: 1.10–1.58) for smokers of more than 20 cigarettes per day. The risk increased with duration of smoking, to reach an OR of 1.33 (95% CI: 1.14–1.54) for more than 40 years of smoking and decreased with increasing time since stopping cigarette smoking (<jats:italic toggle="yes">P</jats:italic> for trend<0.01) and became similar to that of never smokers 10 years after stopping. Risks were somewhat higher for cardia than noncardia gastric cancer. Risks were similar when considering only studies with information on <jats:italic toggle="yes">Helicobacter pylori</jats:italic> infection and comparing all cases to <jats:italic toggle="yes">H. pylori</jats:italic>+ controls only. This study provides the most precise estimate of the detrimental effect of cigarette smoking on the risk of gastric cancer on the basis of individual data, including the relationship with dose and duration, and the decrease in risk following stopping smoking.</jats:p>

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