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Peptic ulcer as mediator of the association between risk of gastric cancer and socioeconomic status, tobacco smoking, alcohol drinking and salt intake.

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Author information

Affiliations

  • 1. Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
      Authors
    • Collatuzzo G 1
    • Negri E 1, 3
    (2 authors)
  • 2. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.
      Authors
    • Alicandro G 2
    (1 author)
  • 3. Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy.
      Authors
    • Bertuccio P 3
    • Pelucchi C 3
    • Bonzi R 3
    • Ferraroni M 3
    • Dalmartello M 3
    • Negri E 1, 3
    • La Vecchia C 3
    (7 authors)
  • 4. Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.
      Authors
    • Palli D 4
    (1 author)
  • 5. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
      Authors
    • Ye W 5
    • Plymoth A 5
    (2 authors)
    • Show all (17)

ORCIDs linked to this article

Show all (10)

Journal of Epidemiology and Community Health, 13 Jul 2022, :jech-2022-219074
https://doi.org/10.1136/jech-2022-219074 PMID: 35831132 

Abstract 

Background

Peptic ulcer disease (PUD) and gastric cancer (GC) are more prevalent in individuals with low socioeconomic status (SES) and share several risk factors. The aim of this study was to investigate the mediating role of PUD in the association between established risk factors and GC.

Methods

We conducted a pooled analysis of 12 studies from the Stomach Cancer Pooling Project Consortium, including a total of 4877 GC cases and 11 808 controls. We explored the mediating role of PUD in the association between SES, tobacco smoking, heavy alcohol drinking and salt intake, and GC. Also, we assessed the ORs and 95% CIs of the risk factors and both PUD and GC.

Results

PUD mediated 36% of the smoking effect mainly among men. Other risk factors were only slightly mediated by PUD (SES, 5.3%; heavy alcohol drinking, 3.3%; and salt intake, 2.5%). No significant difference was found when excluding PUD diagnosed within 2 years from GC.

Conclusions

Our study provides innovative information on the mechanism of stomach mucosal damage leading to PUD and GC, with respect to the effect of tobacco smoking in particular.

Full text links 

Read article at publisher's site: https://doi.org/10.1136/jech-2022-219074

Read article for free, from open access legal sources, via Unpaywall: http://repositori.upf.edu/bitstream/10230/55811/1/Collatuzzo_jech_pept.pdfUnpaywall

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Funding 

Funders who supported this work.

Associazione Italiana per la Ricerca sul Cancro (1)