Risk factors in the development of gastric adenocarcinoma in the general population: A cross-sectional study of the Wuwei Cohort

Several risk factors have been identified for the development of gastric adenocarcinoma (GAC), where the control group was usually a healthy population. However, it is unclear at what stage known risk factor exert their influence toward the progression to cancer. Based on the Wuwei Cohort, we enrolled 1,739 patients with chronic non-atrophic gastritis (no-CAG), 3,409 patients with chronic atrophic gastritis (CAG), 1,757 patients with intestinal metaplasia (IM), 2,239 patients with low-grade dysplasia (LGD), and 182 patients with high-grade dysplasia (HGD) or GAC to assess the risk factors between each two consecutive stages from no-CAG to GAC/HGD using adjusted logistic regression. We found that different groups of risk factors were associated with different stages. Age, occupation of farmer, low annual family income, Helicobacter pylori (H. pylori) infection, drinking, eating hot food, histories of gastritis and peptic ulcer were associated with the development of CAG. Age, illiteracy, H. pylori infection, smoking, eating hot food, eating quickly, and histories of gastritis and gallbladder diseases were associated with the progression to IM from CAG. Male, occupation of farmer and history of peptic ulcer were associated with the development of LGD from IM. Age, male and polyp history appeared to be risk factors associated with the development of GAC/HGD from LGD. In conclusion, it seems that most risk factors function more as a set of switches that initiated the GAC carcinogenesis. H. Pylori eradication and control of other risk factors should be conducted before IM to decrease the incidence of GAC.

[1]  Zhaofeng Chen,et al.  Cohort Profile: A population-based cohort for the study of gastric cancer in northwest area of China (Wuwei Cohort). , 2021, International journal of epidemiology.

[2]  C. la Vecchia,et al.  Gastric cancer: epidemiology, biology, and prevention: a mini review. , 2019, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[3]  Nayoung Kim Chemoprevention of gastric cancer by Helicobacter pylori eradication and its underlying mechanism , 2019, Journal of gastroenterology and hepatology.

[4]  Xi Zeng,et al.  Awareness of risk factors and warning symptoms and attitude towards gastric cancer screening among the general public in China: a cross-sectional study , 2019, BMJ Open.

[5]  J. Kark,et al.  Prevalence and determinants of serological evidence of atrophic gastritis among Arab and Jewish residents of Jerusalem: a cross-sectional study , 2019, BMJ Open.

[6]  Yoosoo Chang,et al.  Smoking and Urinary Cotinine Levels Are Predictors of Increased Risk for Gastric Intestinal Metaplasia. , 2018, Cancer research.

[7]  X. Hua,et al.  Alcohol consumption and risk of gastric cardia adenocarcinoma and gastric noncardia adenocarcinoma: A 16‐year prospective analysis from the NIH‐AARP diet and health cohort , 2018, International journal of cancer.

[8]  A. Jemal,et al.  Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries , 2018, CA: a cancer journal for clinicians.

[9]  N. Nagaich,et al.  Gastric Cancer - An Update , 2018 .

[10]  H. Yoon,et al.  Reversibility of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication ‐ a prospective study for up to 10 years , 2018, Alimentary pharmacology & therapeutics.

[11]  D. Greenwald,et al.  Current Management of Benign Epithelial Gastric Polyps , 2017, Current Treatment Options in Gastroenterology.

[12]  Pengliang Wang,et al.  Alcohol drinking and gastric cancer risk: a meta-analysis of observational studies , 2017, Oncotarget.

[13]  S. Kim,et al.  Gallstone, cholecystectomy and risk of gastric cancer , 2017, Annals of hepato-biliary-pancreatic surgery.

[14]  H. Na,et al.  Molecular Basis of Alcohol-Related Gastric and Colon Cancer , 2017, International journal of molecular sciences.

[15]  J. Yook,et al.  Differences in the prognosis of early gastric cancer according to sex and age , 2016, Therapeutic advances in gastroenterology.

[16]  K. Haustermans,et al.  Gastric cancer , 2016, The Lancet.

[17]  T. Meyer,et al.  Gastric cancer pathogenesis , 2016, Helicobacter.

[18]  Yuqin Liu,et al.  Cancer incidence and mortality in Gansu province, 2012 , 2016, Chinese journal of cancer research = Chung-kuo yen cheng yen chiu.

[19]  Zhi-yi Zhang,et al.  Cancer Incidence and Mortality Survey in Wuwei, Gansu Province, Northwestern China from 2003 to 2012: A Retrospective Population-based Study , 2016, Chinese medical journal.

[20]  A. Jemal,et al.  Cancer statistics in China, 2015 , 2016, CA: a cancer journal for clinicians.

[21]  J. Lagergren,et al.  Marital status, education, and income in relation to the risk of esophageal and gastric cancer by histological type and site , 2016, Cancer.

[22]  Han Liang,et al.  Landscape of dietary factors associated with risk of gastric cancer: A systematic review and dose-response meta-analysis of prospective cohort studies. , 2015, European journal of cancer.

[23]  Yan Li,et al.  Role of Helicobacter pylori in gastric cancer: advances and controversies. , 2015, Discovery medicine.

[24]  S. Terai,et al.  Endoscopic surveillance of gastric cancers after Helicobacter pylori eradication. , 2015, World journal of gastroenterology.

[25]  Nayoung Kim,et al.  Review of Atrophic Gastritis and Intestinal Metaplasia as a Premalignant Lesion of Gastric Cancer , 2015, Journal of cancer prevention.

[26]  Nayoung Kim,et al.  Diagnosis and Management of High Risk Group for Gastric Cancer , 2015, Gut and liver.

[27]  P. Correa,et al.  Gastric cancer. , 2013, Cancer surveys.

[28]  Xiaolin Wang,et al.  Body Mass Index and Risk of Gastric Cancer: A Meta-analysis of a Population with More Than Ten Million from 24 Prospective Studies , 2013, Cancer Epidemiology, Biomarkers & Prevention.

[29]  A. Sonnenberg,et al.  Risk Factors in the Development of Esophageal Adenocarcinoma , 2013, The American Journal of Gastroenterology.

[30]  T. Chen,et al.  The benefit of mass eradication of Helicobacter pylori infection: a community-based study of gastric cancer prevention , 2012, Gut.

[31]  M. Piazuelo,et al.  The gastric precancerous cascade , 2012, Journal of digestive diseases.

[32]  F. Clavel-Chapelon,et al.  Alcohol consumption and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. , 2011, The American journal of clinical nutrition.

[33]  Michelle A. Anderson,et al.  The role of endoscopy in the management of patients with peptic ulcer disease. , 2010, Gastrointestinal endoscopy.

[34]  J. Paul,et al.  Oesophageal and gastric intestinal-type adenocarcinomas show the same male predominance due to a 17 year delayed development in females , 2008, Gut.

[35]  T. Rokkas,et al.  The Long‐term Impact of Helicobacter pylori Eradication on Gastric Histology: a Systematic Review and Meta‐analysis , 2007, Helicobacter.

[36]  Leonor David,et al.  Smoking, Helicobacter pylori Virulence, and Type of Intestinal Metaplasia in Portuguese Males , 2007, Cancer Epidemiology Biomarkers & Prevention.

[37]  F. Clavel-Chapelon,et al.  Socioeconomic position and the risk of gastric and oesophageal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST). , 2007, International journal of epidemiology.

[38]  K. Hemminki,et al.  Socio-economic and occupational risk factors for gastric cancer: a cohort study in Sweden , 2006, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[39]  M. Shah Gastric cancer: An update , 2006, Current oncology reports.

[40]  F. Chan,et al.  Factors predicting progression of gastric intestinal metaplasia: results of a randomised trial on Helicobacter pylori eradication , 2004, Gut.

[41]  M. Plummer,et al.  Environmental factors in Helicobacter pylori-related gastric precancerous lesions in Venezuela. , 2004, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[42]  P. Correa,et al.  Human gastric carcinogenesis: a multistep and multifactorial process--First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. , 1992, Cancer research.

[43]  C. la Vecchia,et al.  Food temperature and gastric cancer , 1990, International journal of cancer.

[44]  C. la Vecchia,et al.  A meta-analysis on alcohol drinking and gastric cancer risk. , 2012, Annals of oncology : official journal of the European Society for Medical Oncology.

[45]  F. Bosman,et al.  WHO Classification of Tumours of the Digestive System , 2010 .