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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

  • Giulia Collatuzzo
  • , Gianfranco Alicandro
  • , Paola Bertuccio
  • , Claudio Pelucchi
  • , Rossella Bonzi
  • , Domenico Palli
  • , Monica Ferraroni
  • , Weimin Ye
  • , Amelie Plymoth
  • , David Zaridze
  • , Dmitry Maximovich
  • , Nuria Aragones
  • , Gemma Castaño-Vinyals
  • , Jesus Vioque
  • , Manoli Garcia De La Hera
  • , Zuo Feng Zhang
  • , Jinfu Hu
  • , Lizbeth Lopez-Carrillo
  • , Malaquías López-Cervantes
  • , Michela Dalmartello
  • Lina Mu, Mary H. Ward, Charles Rabkin, Guo Pei Yu, M. Constanza Camargo, Maria Paula Curado, Nuno Lunet, Eva Negri, Carlo La Vecchia, Paolo Boffetta
  • University of Bologna
  • University of Milan
  • IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
  • University of Pavia
  • Institute for the Study and Prevention of Cancer
  • Karolinska Institutet
  • Russian N.N. Blokhin Cancer Research Centre
  • Centro de Investigación Biomédicaen Red de Epidemiología y Salud Pública (CIBERESP)
  • Public Health Division
  • (ISGlobal) Instituto de Salud Global de Barcelona
  • Hospital del Mar
  • Pompeu Fabra University
  • Miguel Hernández University
  • University of California at Los Angeles
  • Harbin Medical University
  • Instituto Nacional de Salud Publica
  • UNAM. Coyoacán
  • National Institutes of Health
  • Peking University
  • A.C.Camargo Cancer Center
  • University of Porto
  • Laboratorio para a Investigacão Integrativa e Translacional em Saude Populacional (ITR)
  • Stony Brook University

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

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.

Original languageEnglish
Pages (from-to)861-866
Number of pages6
JournalJournal of Epidemiology and Community Health
Volume76
Issue number10
DOIs
StatePublished - Oct 1 2022

Keywords

  • Alcohol
  • Gastric cancer
  • Mediation analysis
  • Peptic ulcer disease
  • Salt
  • Smoking
  • Socioeconomic status

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