Abstract
Whether the risk of gastric cancer varies by the types of meat consumption still remains disputable. The purpose of this meta-analysis was to identify the exact associations that red, processed, and white meat have with gastric cancer. We searched relevant studies in Medline, EMBASE, and the Cochrane Library before November 2018, including cohort and case-control studies. We used random-effect models to estimate the adjusted relative risk (RR), and Egger’s tests to evaluate publication bias. Through stepwise screening, 43 studies were included in this analysis (11 cohort studies and 32 case-control studies with 16,572 cases). In a meta-analysis for the highest versus lowest categories of meat consumption, both red (RR: 1.41, 95% confidence interval (CI): 1.21–1.66) and processed (RR: 1.57, 95% CI: 1.37–1.81) meat consumption were positively associated with gastric cancer risk, while white meat consumption was negatively associated with gastric cancer risk (RR: 0.80, 95% CI: 0.69–0.92). In a dose–response meta-analysis, the RRs of gastric cancer were 1.26 (95% CI: 1.11–1.42) for every 100 g/day increment in red meat consumption, 1.72 (95% CI: 1.36–2.18) for every 50 g/day increment in processed meat consumption, and 0.86 (95% CI: 0.64–1.15) for every 100 g/day increment in white meat consumption. The increase of white meat consumption may reduce the risk of gastric cancer, while red or processed meat may increase the risk of gastric cancer. Further studies are required to identify these associations, especially between white meat and gastric cancer.
Highlights
For over 50 years, the incidence of gastric cancer has declined worldwide [1]
In a comprehensive and updated meta-analysis, we found that high consumption of red and processed meat was significantly associated with an increased risk of gastric cancer
Increased risk, respectively), while that of white meat was significantly associated with a decreased risk of gastric cancer (20% decreased risk)
Summary
For over 50 years, the incidence of gastric cancer has declined worldwide [1]. Gastric cancer, remains the fifth most common cancer and the third major cause of cancer death globally [2], which has an enormously negative effect on public health. Meat consumption has steadily increased worldwide in recent years, and red and processed meat, which represent the majority of meat intake, might be a latent risk factor of stomach cancer [4,5]. The CUP, which was published this year and based on the Third Expert Report in 2018, changed its judgement on the effect of processed meat consumption on gastric non-cardia cancer from ‘strong evidence’ to ‘limited evidence’ [7]. There have been no dose–response meta-analysis to examine the associations between processed or white meat intake and gastric cancer risk. This systematic review and updated meta-analysis was conducted to identify the exact association that red, processed, and white meat have with gastric cancer
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