Diets rich in vegetables and fruit have been associated with reduced risk of gastric cancer, and there is suggestive evidence that citrus fruits have a protective role. This study aimed at evaluating and quantifying the association between citrus fruit consumption and gastric cancer risk. We conducted a one-stage pooled analysis including 6340 cases and 14,490 controls from 15 case-control studies from the Stomach cancer Pooling (StoP) Project consortium. Odds ratio (OR) and the corresponding 95% confidence intervals (CI) of gastric cancer across study-specific tertiles of citrus fruit intake (grams/week) were estimated by generalized linear mixed effect models, with logistic link function and random intercept for each study. The models were adjusted for sex, age, and the main recognized risk factors for gastric cancer. Compared to the first third of the distribution, the adjusted pooled ORs (95% CI) for the highest third was 0.80 (0.73-0.87). The protective effect of citrus fruits increased progressively until three servings/week and levelled off thereafter. The magnitude of the association was similar between cancer sub-sites and histotype. The analysis by geographic area showed no association in studies from the Americas. Our data confirm an inverse association between citrus fruit intake and gastric cancer and provide precise estimates of the magnitude of the association. However, the null association found in studies from America and in some previous cohort studies prevent to draw definite conclusions on a protective effect of citrus fruit consumption.

Citrus fruit intake and gastric cancer: the Stomach cancer Pooling (StoP) project consortium / P. Bertuccio, G. Alicandro, M. Rota, C. Pelucchi, R. Bonzi, C. Galeone, F. Bravi, K.C. Johnson, J. Hu, D. Palli, M. Ferraroni, L. López-Carrillo, N. Lunet, A. Ferro, R. Malekzadeh, D. Zaridze, D. Maximovitch, J. Vioque, E.M. Navarrete-Munoz, M. Pakseresht, R.U. Hernández-Ramírez, M. López-Cervantes, M. Ward, F. Pourfarzi, S. Tsugane, A. Hidaka, Z. Zhang, R.C. Kurtz, P. Lagiou, A. Lagiou, P. Boffetta, S. Boccia, E. Negri, C. La Vecchia. - In: INTERNATIONAL JOURNAL OF CANCER. - ISSN 0020-7136. - 144:12(2019), pp. 2936-2944. [10.1002/ijc.32046]

Citrus fruit intake and gastric cancer: the Stomach cancer Pooling (StoP) project consortium

P. Bertuccio
Primo
;
G. Alicandro
Secondo
;
M. Rota;C. Pelucchi;R. Bonzi;C. Galeone;F. Bravi;M. Ferraroni;E. Negri;C. La Vecchia
2019

Abstract

Diets rich in vegetables and fruit have been associated with reduced risk of gastric cancer, and there is suggestive evidence that citrus fruits have a protective role. This study aimed at evaluating and quantifying the association between citrus fruit consumption and gastric cancer risk. We conducted a one-stage pooled analysis including 6340 cases and 14,490 controls from 15 case-control studies from the Stomach cancer Pooling (StoP) Project consortium. Odds ratio (OR) and the corresponding 95% confidence intervals (CI) of gastric cancer across study-specific tertiles of citrus fruit intake (grams/week) were estimated by generalized linear mixed effect models, with logistic link function and random intercept for each study. The models were adjusted for sex, age, and the main recognized risk factors for gastric cancer. Compared to the first third of the distribution, the adjusted pooled ORs (95% CI) for the highest third was 0.80 (0.73-0.87). The protective effect of citrus fruits increased progressively until three servings/week and levelled off thereafter. The magnitude of the association was similar between cancer sub-sites and histotype. The analysis by geographic area showed no association in studies from the Americas. Our data confirm an inverse association between citrus fruit intake and gastric cancer and provide precise estimates of the magnitude of the association. However, the null association found in studies from America and in some previous cohort studies prevent to draw definite conclusions on a protective effect of citrus fruit consumption.
citrus fruits; gastric cancer; pooled analysis; case-control studies
Settore MED/01 - Statistica Medica
   Genetic and Lifestyle Factors in gastric cancer epidemiology: enhancing research through the establishment of an international consortium
   MINISTERO DELLA SALUTE
   81/GR-2011-02347943

   A global collaborative re-analysis of gastic cancer data: advancing etiology and prevention of gastric cancer - 2° ANNO
   FONDAZIONE AIRC PER LA RICERCA SUL CANCRO ETS
   IG 2015 Id.16715
2019
6-dic-2018
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/610049
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