Fruits and vegetables intake and gastric cancer risk: A pooled analysis within the Stomach cancer Pooling Project

  • Ana Ferro
    EPIUnit – Instituto de Saúde Pública Universidade do Porto Porto Portugal
  • Ana Rute Costa
    EPIUnit – Instituto de Saúde Pública Universidade do Porto Porto Portugal
  • Samantha Morais
    EPIUnit – Instituto de Saúde Pública Universidade do Porto Porto Portugal
  • Paola Bertuccio
    Department of Clinical Sciences and Community Health University of Milan Milan Italy
  • Matteo Rota
    Department of Clinical Sciences and Community Health University of Milan Milan Italy
  • Claudio Pelucchi
    Department of Clinical Sciences and Community Health University of Milan Milan Italy
  • Jinfu Hu
    Harbin Medical University Harbin China
  • Kenneth C. Johnson
    School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa Ottawa Ontario Canada
  • Zuo‐Feng Zhang
    Department of Epidemiology UCLA Fielding School of Public Health and Jonsson, Comprehensive Cancer Center Los Angeles California
  • Domenico Palli
    Cancer Risk Factors and Life‐Style Epidemiology Unit Institute for Cancer Research, Prevention and Clinical Network, ISPRO Florence Italy
  • Monica Ferraroni
    Department of Clinical Sciences and Community Health University of Milan Milan Italy
  • Guo‐Pei Yu
    Medical Informatics Center Peking University Peking China
  • Rossella Bonzi
    Department of Clinical Sciences and Community Health University of Milan Milan Italy
  • Bárbara Peleteiro
    EPIUnit – Instituto de Saúde Pública Universidade do Porto Porto Portugal
  • Lizbeth López‐Carrillo
    Mexico National Institute of Public Health Morelos Mexico
  • Shoichiro Tsugane
    Epidemiology and Prevention Group Center for Public Health Sciences, National Cancer Center Tokyo Japan
  • Gerson Shigueaki Hamada
    Nikkei Disease Prevention Center São Paulo Brazil
  • Akihisa Hidaka
    Epidemiology and Prevention Group Center for Public Health Sciences, National Cancer Center Tokyo Japan
  • Reza Malekzadeh
    Digestive Oncology Research Center, Digestive Disease Research Institute Tehran University of Medical Sciences Tehran Iran
  • David Zaridze
    Department of Epidemiology and Prevention Russian N.N. Blokhin Cancer Research Center Moscow Russia
  • Dmitry Maximovich
    Department of Epidemiology and Prevention Russian N.N. Blokhin Cancer Research Center Moscow Russia
  • Jesus Vioque
    Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) Madrid Spain
  • Eva M. Navarrete‐Muñoz
    Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) Madrid Spain
  • Juan Alguacil
    Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) Madrid Spain
  • Gemma Castaño‐Vinyals
    Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) Madrid Spain
  • Alicja Wolk
    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
  • Raúl Ulises Hernández‐Ramírez
    Department of Biostatistics Yale School of Public Health, Yale School of Medicine New Haven Connecticut
  • Mohammadreza Pakseresht
    Digestive Oncology Research Center, Digestive Disease Research Institute Tehran University of Medical Sciences Tehran Iran
  • Mary H. Ward
    Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville Maryland
  • Farhad Pourfarzi
    Digestive Oncology Research Center, Digestive Disease Research Institute Tehran University of Medical Sciences Tehran Iran
  • Lina Mu
    Department of Epidemiology and Environmental Health, School of Public Health and Health Professions University at Buffalo Buffalo New York
  • Malaquias López‐Cervantes
    Facultad de Medicina, UNAM Coyoacán Mexico
  • Roberto Persiani
    Dipartimento Scienze Gastroenterologiche, Endocrino‐Metaboliche e Nefro‐Urologiche Fondazione Policlinico Universitario Agostino Gemelli IRCCS Roma Italy
  • Robert C. Kurtz
    Department of Medicine Memorial Sloan Kettering Cancer Centre New York New York
  • Areti Lagiou
    Department of Public and Community Health, School of Health Sciences University of West Attica Egaleo Greece
  • Pagona Lagiou
    Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine National and Kapodistrian University of Athens Athens Greece
  • Paolo Boffetta
    The Tisch Cancer Institute, Department of Hematology and Oncology Icahn School of Medicine at Mount Sinai New York New York
  • Stefania Boccia
    Sezione di Igiene, Dipartimento Universitario di Scienze della Vita e Sanità Pubblica Università Cattolica del Sacro Cuore Roma Italy
  • Eva Negri
    Department of Biomedical and Clinical Sciences University of Milan Milan Italy
  • Maria Constanza Camargo
    Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville Maryland
  • Maria Paula Curado
    Centro Internacional de Pesquisa A. C. Camargo Cancer Center São Paulo Brazil
  • Carlo La Vecchia
    Department of Clinical Sciences and Community Health University of Milan Milan Italy
  • Nuno Lunet
    EPIUnit – Instituto de Saúde Pública Universidade do Porto Porto Portugal

抄録

<jats:title>Abstract</jats:title><jats:p>A low intake of fruits and vegetables is a risk factor for gastric cancer, although there is uncertainty regarding the magnitude of the associations. In our study, the relationship between fruits and vegetables intake and gastric cancer was assessed, complementing a previous work on the association betweenconsumption of citrus fruits and gastric cancer. Data from 25 studies (8456 cases and 21 133 controls) with information on fruits and/or vegetables intake were used. A two‐stage approach based on random‐effects models was used to pool study‐specific adjusted (sex, age and the main known risk factors for gastric cancer) odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Exposure‐response relations, including linear and nonlinear associations, were modeled using one‐ and two‐order fractional polynomials. Gastric cancer risk was lower for a higher intake of fruits (OR: 0.76, 95% CI: 0.64‐0.90), noncitrus fruits (OR: 0.86, 95% CI: 0.73‐1.02), vegetables (OR: 0.68, 95% CI: 0.56‐0.84), and fruits and vegetables (OR: 0.61, 95% CI: 0.49‐0.75); results were consistent across sociodemographic and lifestyles categories, as well as study characteristics. Exposure‐response analyses showed an increasingly protective effect of portions/day of fruits (OR: 0.64, 95% CI: 0.57‐0.73 for six portions), noncitrus fruits (OR: 0.71, 95% CI: 0.61‐0.83 for six portions) and vegetables (OR: 0.51, 95% CI: 0.43‐0.60 for 10 portions). A protective effect of all fruits, noncitrus fruits and vegetables was confirmed, supporting further dietary recommendations to decrease the burden of gastric cancer.</jats:p>

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