Tobacco smoking and gastric cancer: meta-analyses of published data versus pooled analyses of individual participant data (StoP Project)

  • Ana Ferro
    EPI Unit, Instituto de Saúde Pública, Universidade do Porto
  • Samantha Morais
    EPI Unit, Instituto de Saúde Pública, Universidade do Porto
  • Matteo Rota
    Department of Biomedical and Clinical Sciences
  • Claudio Pelucchi
    Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  • Paola Bertuccio
    Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  • Rossella Bonzi
    Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  • Carlotta Galeone
    Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  • 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, Aichi Cancer Center Research Institute, Nagoya, Japan
  • Hidemi Ito
    Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
  • Jinfu Hu
    Harbin Medical University, Harbin
  • Kenneth C. Johnson
    School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • 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, Milan, Italy
  • Joshua Muscat
    The Tisch Cancer Institute, Mount Sinai School of Medicine
  • 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
    Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)
  • Jesus Vioque
    Miguel Hernandez University and ISABIAL-FISABIO Foundation, Campus San Juan, Alicante, Spain
  • Eva M. Navarrete-Muñoz
    Miguel Hernandez University and ISABIAL-FISABIO Foundation, Campus San Juan, Alicante, Spain
  • Mohammadreza Pakseresht
    Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, 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, New York
  • Roberta Pastorino
    Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore
  • Robert C. Kurtz
    Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York
  • 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
  • Stefania Boccia
    Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore
  • Eva Negri
    Department of Biomedical and Clinical Sciences
  • Carlo La Vecchia
    Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  • Bárbara Peleteiro
    EPI Unit, Instituto de Saúde Pública, Universidade do Porto
  • Nuno Lunet
    EPI Unit, Instituto de Saúde Pública, Universidade do Porto

抄録

<jats:p>Tobacco smoking is one of the main risk factors for gastric cancer, but the magnitude of the association estimated by conventional systematic reviews and meta-analyses might be inaccurate, due to heterogeneous reporting of data and publication bias. We aimed to quantify the combined impact of publication-related biases, and heterogeneity in data analysis or presentation, in the summary estimates obtained from conventional meta-analyses. We compared results from individual participant data pooled-analyses, including the studies in the Stomach Cancer Pooling (StoP) Project, with conventional meta-analyses carried out using only data available in previously published reports from the same studies. From the 23 studies in the StoP Project, 20 had published reports with information on smoking and gastric cancer, but only six had specific data for gastric cardia cancer and seven had data on the daily number of cigarettes smoked. Compared to the results obtained with the StoP database, conventional meta-analyses overvalued the relation between ever smoking (summary odds ratios ranging from 7% higher for all studies to 22% higher for the risk of gastric cardia cancer) and yielded less precise summary estimates (SE ≤2.4 times higher). Additionally, funnel plot asymmetry and corresponding hypotheses tests were suggestive of publication bias. Conventional meta-analyses and individual participant data pooled-analyses reached similar conclusions on the direction of the association between smoking and gastric cancer. However, published data tended to overestimate the magnitude of the effects, possibly due to publication biases and limited the analyses by different levels of exposure or cancer subtypes.</jats:p>

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