Abstract
The results of prospective cohort studies regarding the role of salt intake and subsequent gastric cancer risk are inconsistent. Thus, we performed a systematic review and meta-analysis to summarize the strength of the association of salt intake with gastric cancer morbidity and mortality. PubMed, EmBase, and Cochrane Library were systematically searched to identify eligible studies published throughout September 2021. The effect estimates with 95% confidence intervals (CIs) for gastric cancer morbidity or mortality in each study were applied to calculate the pooled results; these analyses were performed using the random-effects model. Twenty-six prospective cohort studies involving 4,956,350 individuals were selected; these studies reported 19,301 cases of gastric cancer and 2,871 cases of gastric cancer-associated mortality. High (RR: 1.25; 95%CI: 1.10–1.41; P = 0.001) or moderate (RR: 1.20; 95%CI: 1.04–1.38; P = 0.012) salt intake was associated with a greater risk of gastric cancer. High pickled food intake was associated with an increased gastric cancer risk (RR: 1.28; 95%CI: 1.05–1.57; P = 0.017), while moderate pickled foods intake had no significant effect on gastric cancer risk (RR: 1.10; 95%CI: 0.88–1.37; P = 0.390). Neither high (RR: 1.14; 95%CI: 0.95–1.36; P = 0.161) nor moderate (RR: 1.10; 95%CI: 0.87–1.40; P = 0.436) salted fish intake were associated with gastric cancer risk. A high intake of processed meat was significantly associated with a higher risk of gastric cancer (RR: 1.24; 95%CI: 1.03–1.49; P = 0.023), while moderate processed meat intake had no significant effect on the gastric cancer risk (RR: 1.01; 95%CI: 0.92–1.11; P = 0.844). High (RR: 1.04; 95%CI: 0.90–1.19; P = 0.626) and moderate (RR: 1.02; 95%CI: 0.94–1.11; P = 0.594) miso-soup intake had no effects on the gastric cancer risk. High intakes of salt, pickled food, and processed meat are associated with significantly increased risks of gastric cancer; these increased risks are also seen when participants consumed moderate amounts of salt.
Highlights
Gastric cancer is the fifth most common type of cancer and is the third leading cause of cancer-related deaths worldwide [1]
Studies designed as prospective cohort studies and those that assessed the association of dietary salt intake with the risk of gastric cancer were eligible for inclusion in our study, and the publication language was restricted to English
High pickled food and processed meat intakes were associated with an increased risk of gastric cancer, while moderate pickled food and processed meat intakes were not
Summary
Gastric cancer is the fifth most common type of cancer and is the third leading cause of cancer-related deaths worldwide [1]. 70% of new gastric cancer cases occurred in developing countries, especially, in China. Studies have already found several lifestyle-associated factors could prevent the risk of gastric cancer, including the intake of citrus fruits [2], flavonols [3], dietary nitrates, nitrites, nitrosamines [4], a Mediterranean diet [5], dairy products [6], vitamin A, vitamin C, vitamin E [7], cruciferous vegetables [8], and dietary fiber [9], and physical activity [10]. Several potential risk factors for gastric cancer, including intake of coffee, dietary fat, red meat, obesity, and smoking, have been identified [11,12,13,14,15]. Other dietary factors should be identified to further prevent the risk of gastric cancer
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