A meta-analysis of factors influencing the development of gastric cancer in Chinese populations / 预防医学

ABSTRACT

Objective@# To investigate the factors influencing the development of gastric cancer in Chinese populations, so as provide insights into creating a model for predicting gastric cancer incidence among Chinese populations.@*Methods@#The case-control and cohort studies pertaining to factors affecting the development of gastric cancer were retrieved in electronic Chinese and English databases, including CNKI, Wanfang Data, VIP, PubMed, Web of Science and Embase from their inception until September 30, 2021. A meta-analysis was performed using R package version 4.1.0. Sensitivity analysis was performed using the “leave-one-out” evaluation procedure, and the publication bias was evaluated using the Egger regression test and the trim-and-fill procedure. @*Results@# A total of 5 301 publications were screened and 116 eligible studies were included in the final analysis, including 103 case-control studies and 13 cohort studies, which covered approximately 3.23 million study subjects. A total of 45 factors affecting the development of gastric cancer were collected, and there were less than 4 publications reporting 7 factors, which were only qualitatively described. There were 38 factors included in the final meta-analysis. A total of 21 factors were identified as risk factors of gastric cancer, including a history of gastrointestinal diseases (pooled OR=4.85, 95%CI 3.74-6.29), H. pylori infection (pooled OR=3.18, 95%CI 2.35-4.32), binge eating and drinking (pooled OR=2.88, 95%CI 2.09-3.97) and a family history of tumors (pooled OR=2.78, 95%CI 2.17-3.56), and 10 factors as protective factors, including vegetable intake (pooled OR=0.48, 95%CI 0.38-0.61), tea consumption (pooled OR=0.55, 95%CI 0.47-0.64), administration of aspirin (pooled OR=0.53, 95%CI 0.31-0.92) and administration of statins (pooled OR=0.59, 95%CI 0.44-0.80). Sensitivity analyses of eating moldy food frequently, white meat intake, favoring spicy food and administration of sulfonylureas were not robust. Following correction with the trim-and-fill procedure, there was still a publication bias pertaining to high income, diabetes, administration of stains, alcohol consumption, tea consumption and white meat intake.@*Conclusions@# The development of gastric cancer is associated with a medical history of gastrointestinal disease, H. pylori infection, family history of tumors and poor dietary habits. Risk and protective factors of gastric cancer are recommended to be included in models used to predict gastric cancer incidence among Chinese populations.