Reproductive Factors, Hormonal Interventions, and Gastric Cancer Risk in the Stomach Cancer Pooling (StoP) Project

Overview

Journal Cancer Causes Control

Specialties Oncology
Public Health

Date 2023 Dec 20

PMID 38123742

Authors

Minkyo Song

Harindra Jayasekara

Claudio Pelucchi

Charles S Rabkin

Kenneth C Johnson

Jinfu Hu

Domenico Palli

Monica Ferraroni

Linda M Liao

Rossella Bonzi

David Zaridze

Dmitry Maximovitch

Nuria Aragones

Vicente Martin

Gemma Castano-Vinyals

Marcela Guevara

Shoichiro Tsugane

Gerson Shigueaki Hamada

Akihisa Hidaka

Eva Negri

Mary H Ward

Rashmi Sinha

Areti Lagiou

Pagona Lagiou

Paolo Boffetta

Maria Paula Curado

Nuno Lunet

Jesus Vioque

Zuo-Feng Zhang

Carlo La Vecchia

M Constanza Camargo

Affiliations

Soon will be listed here.

Abstract

Background: Gastric cancer incidence is higher in men, and a protective hormone-related effect in women is postulated. We aimed to investigate and quantify the relationship in the Stomach cancer Pooling (StoP) Project consortium.

Methods: A total of 2,084 cases and 7,102 controls from 11 studies in seven countries were included. Summary odds ratios (ORs) and 95% confidence intervals (CIs) assessing associations of key reproductive factors and menopausal hormone therapy (MHT) with gastric cancer were estimated by pooling study-specific ORs using random-effects meta-analysis.

Results: A duration of fertility of ≥ 40 years (vs. < 20), was associated with a 25% lower risk of gastric cancer (OR = 0.75; 95% CI: 0.58-0.96). Compared with never use, ever, 5-9 years and ≥ 10 years use of MHT in postmenopausal women, showed ORs of 0.73 (95% CI: 0.58-0.92), 0.53 (95% CI: 0.34-0.84) and 0.71 (95% CI: 0.50-1.00), respectively. The associations were generally similar for anatomical and histologic subtypes.

Conclusion: Our results support the hypothesis that reproductive factors and MHT use may lower the risk of gastric cancer in women, regardless of anatomical or histologic subtypes. Given the variation in hormones over the lifespan, studies should address their effects in premenopausal and postmenopausal women. Furthermore, mechanistic studies may inform potential biological processes.

References

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Thrift A, El-Serag H . Burden of Gastric Cancer. Clin Gastroenterol Hepatol. 2019; 18(3):534-542. PMC: 8859863. DOI: 10.1016/j.cgh.2019.07.045. View

Allemani C, Weir H, Carreira H, Harewood R, Spika D, Wang X . Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet. 2014; 385(9972):977-1010. PMC: 4588097. DOI: 10.1016/S0140-6736(14)62038-9. View

de Martel C, Forman D, Plummer M . Gastric cancer: epidemiology and risk factors. Gastroenterol Clin North Am. 2013; 42(2):219-40. DOI: 10.1016/j.gtc.2013.01.003. View

Sipponen P, Correa P . Delayed rise in incidence of gastric cancer in females results in unique sex ratio (M/F) pattern: etiologic hypothesis. Gastric Cancer. 2002; 5(4):213-9. DOI: 10.1007/s101200200037. View

Freedman N, Ahn J, Hou L, Lissowska J, Zatonski W, Yeager M . Polymorphisms in estrogen- and androgen-metabolizing genes and the risk of gastric cancer. Carcinogenesis. 2008; 30(1):71-7. PMC: 2639034. DOI: 10.1093/carcin/bgn258. View

Ishigaki K, Akiyama M, Kanai M, Takahashi A, Kawakami E, Sugishita H . Large-scale genome-wide association study in a Japanese population identifies novel susceptibility loci across different diseases. Nat Genet. 2020; 52(7):669-679. PMC: 7968075. DOI: 10.1038/s41588-020-0640-3. View

Camargo M, Goto Y, Zabaleta J, Morgan D, Correa P, Rabkin C . Sex hormones, hormonal interventions, and gastric cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2011; 21(1):20-38. PMC: 3315355. DOI: 10.1158/1055-9965.EPI-11-0834. View

Pelucchi C, Lunet N, Boccia S, Zhang Z, Praud D, Boffetta P . The stomach cancer pooling (StoP) project: study design and presentation. Eur J Cancer Prev. 2014; 24(1):16-23. DOI: 10.1097/CEJ.0000000000000017. View

10.

Palli D, Galli M, Caporaso N, Cipriani F, Decarli A, Saieva C . Family history and risk of stomach cancer in Italy. Cancer Epidemiol Biomarkers Prev. 1994; 3(1):15-8. View

11.

La Vecchia C, DAvanzo B, Negri E, Decarli A, Benichou J . Attributable risks for stomach cancer in northern Italy. Int J Cancer. 1995; 60(6):748-52. DOI: 10.1002/ijc.2910600603. View

12.

Lagiou P, Samoli E, Lagiou A, Peterson J, Tzonou A, Dwyer J . Flavonoids, vitamin C and adenocarcinoma of the stomach. Cancer Causes Control. 2004; 15(1):67-72. DOI: 10.1023/B:CACO.0000016619.18041.b0. View

13.

Mao Y, Hu J, Semenciw R, White K . Active and passive smoking and the risk of stomach cancer, by subsite, in Canada. Eur J Cancer Prev. 2002; 11(1):27-38. DOI: 10.1097/00008469-200202000-00005. View

14.

Zaridze D, Borisova E, Maximovitch D, Chkhikvadze V . Alcohol consumption, smoking and risk of gastric cancer: case-control study from Moscow, Russia. Cancer Causes Control. 2000; 11(4):363-71. DOI: 10.1023/a:1008907924938. View

15.

Castano-Vinyals G, Aragones N, Perez-Gomez B, Martin V, Llorca J, Moreno V . Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design. Gac Sanit. 2015; 29(4):308-15. DOI: 10.1016/j.gaceta.2014.12.003. View

16.

Nishimoto I, Hamada G, Kowalski L, Rodrigues J, Iriya K, Sasazuki S . Risk factors for stomach cancer in Brazil (I): a case-control study among non-Japanese Brazilians in São Paulo. Jpn J Clin Oncol. 2002; 32(8):277-83. DOI: 10.1093/jjco/hyf060. View

17.

Hamada G, Kowalski L, Nishimoto I, Rodrigues J, Iriya K, Sasazuki S . Risk factors for stomach cancer in Brazil (II): a case-control study among Japanese Brazilians in São Paulo. Jpn J Clin Oncol. 2002; 32(8):284-90. DOI: 10.1093/jjco/hyf061. View

18.

Foschi R, Lucenteforte E, Bosetti C, Bertuccio P, Tavani A, La Vecchia C . Family history of cancer and stomach cancer risk. Int J Cancer. 2008; 123(6):1429-32. DOI: 10.1002/ijc.23688. View

19.

Ward M, Heineman E, Markin R, Weisenburger D . Adenocarcinoma of the stomach and esophagus and drinking water and dietary sources of nitrate and nitrite. Int J Occup Environ Health. 2008; 14(3):193-7. PMC: 2797489. DOI: 10.1179/oeh.2008.14.3.193. View

20.

Schatzkin A, Subar A, Thompson F, Harlan L, Tangrea J, Hollenbeck A . Design and serendipity in establishing a large cohort with wide dietary intake distributions : the National Institutes of Health-American Association of Retired Persons Diet and Health Study. Am J Epidemiol. 2001; 154(12):1119-25. DOI: 10.1093/aje/154.12.1119. View