Abstract
An increased risk of gastric cancer for pickled vegetable and salted fish intake has been suggested, yet the lack of a dose-response association warrants a quantitative analysis. We conducted a meta-analysis, combining results from our analysis of two large Korean cohort studies and those from previous prospective cohort studies. We investigated the association of pickled vegetable and salted fish intake with gastric cancer in the Korean Genome Epidemiology Study and the Korean Multi-center Cancer Cohort Study using Cox proportional hazard models. We then searched for observational studies published until November 2019 and conducted both dose-response and categorical meta-analyses. The pooled relative risk (RR) of gastric cancer incidence was 1.15 (95% Confidence Interval (CI), 1.07–1.23) for 40 g/day increment in pickled vegetable intake in a dose-response manner (P for nonlinearity = 0.11). As for salted fish intake, the pooled risk of gastric cancer incidence was 1.17 (95% CI, 0.99–1.38) times higher, comparing the highest to the lowest intake. Our findings supported the evidence that high intake of pickled vegetable and salted fish is associated with elevated risk of gastric cancer incidence.
Highlights
IntroductionThe fifth most common cancer, is the third most common cause of death from cancer.Among Eastern Asian countries, where gastric cancer ranks the second highest for both incidence and cancer mortality, South Korea has the highest rate of gastric cancer in both sexes (age-standardized incidence rate of 39.6 and mortality rate of 7.0 per 100,000 population in 2018) [1,2,3]
Gastric cancer, the fifth most common cancer, is the third most common cause of death from cancer.Among Eastern Asian countries, where gastric cancer ranks the second highest for both incidence and cancer mortality, South Korea has the highest rate of gastric cancer in both sexes [1,2,3]
In the Korean Multi-center Cancer Cohort (KMCC), we identified 81 cases of gastric cancer incidence during an average of
Summary
The fifth most common cancer, is the third most common cause of death from cancer.Among Eastern Asian countries, where gastric cancer ranks the second highest for both incidence and cancer mortality, South Korea has the highest rate of gastric cancer in both sexes (age-standardized incidence rate of 39.6 and mortality rate of 7.0 per 100,000 population in 2018) [1,2,3]. The fifth most common cancer, is the third most common cause of death from cancer. Cancers 2020, 12, 996 treatments targeting gastric cancer, it remains a life-threatening neoplasm worldwide [4]. Gastric cancer is a multifactorial disease, with several environmental factors such as diet and Helicobacter pylori (H. pylori) infection contributing to the carcinogenesis [5]. The synergistic effect between dietary salt intake and H. pylori infection, a class I carcinogen of gastric cancer, has been previously observed [6,7,8]. Dietary salt intake induces mucosal damage and gastric cell proliferation, enabling the subsequent
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