Journal of Gastric Cancer

  • 제25권2호
  • /
  • Pages.285-302
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  • 2025
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Environmental Protective and Risk Factors for Gastric Cancer: An Umbrella Review and Reanalysis of Meta-Analyses

  • Seungwon Kim (Korea University Anam Hospital) ;
  • Min Seo Kim (Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Samsung Medical Center) ;
  • Yeongkeun Kwon (Division of Foregut Surgery, Korea University College of Medicine) ;
  • Jae-Seok Min (Division of Foregut Surgery, Korea University College of Medicine) ;
  • Ahmad Alromi (Department of General Surgery, The Jordanian Ministry of Health, Princes Hamzh Hospital) ;
  • Jong Yeob Kim (Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Samsung Medical Center) ;
  • Jueon Kim (Kyung Hee University College of Medicine) ;
  • Jae Il Shin (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Dong Keon Yon (Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University) ;
  • Yuhyeon Chu (Ewha Womans University College of Medicine) ;
  • Sungsoo Park (Division of Foregut Surgery, Korea University College of Medicine)
  • 투고 : 2024.07.30
  • 심사 : 2024.11.20
  • 발행 : 2025.04.01
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초록

Purpose: Despite extensive research on gastric cancer (GC), efforts to consolidate the numerous associations between possible factors and GC risk remain lacking. This systematic review aimed to provide an overview of potential GC-associated pairs. Materials and Methods: We systematically searched PubMed, Embase, and Cochrane databases, from their inception to April 23, 2022, for eligible systematic reviews and meta-analyses to investigate the association between any possible factors and GC risk. After the inclusion of 75 systematic reviews and meta-analyses, 117 association pairs were examined. We reanalyzed the included meta-analyses and produced effect estimates using uniform analytical models. The certainty of the evidence for each association pair was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Results: Iatrogenic factors, including antibacterial drugs, were associated with an increased risk of GC. Epstein-Barr virus and Helicobacter pylori infections were also associated with an increased risk of GC, while human T-lymphotropic virus type 1 (HTLV-1) infections were associated with a reduced risk. Dietary habit was a major factor influencing moderate to high GRADE associations. Positive associations were observed for heavy alcohol consumption (relative risk [RR], 1.13; 95% confidence interval [CI], 1.06-1.12), refined grain consumption (RR, 1.36; 95% CI, 1.21-1.53), and habitual salt intake (RR, 1.41; 95% CI, 1.04-1.91). Conclusions: The associations between GC risk and dietary and nutritional factors were considerably heterogeneous, whereas other factors, such as lifestyle and iatrogenic and environmental exposures, were consistent across regions. Therefore, dietary interventions for GC prevention should be tailored specific to regions.

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