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Citrus Fruit Intake and Gastric Cancer: The Stomach Cancer Pooling (Stop) Project Consortium Publisher Pubmed



Bertuccio P1 ; Alicandro G1 ; Rota M1 ; Pelucchi C1 ; Bonzi R1 ; Galeone C1 ; Bravi F1 ; Johnson KC2 ; Hu J3 ; Palli D4 ; Ferraroni M1 ; Lopezcarrillo L5 ; Lunet N6, 7 ; Ferro A7 Show All Authors
Authors
  1. Bertuccio P1
  2. Alicandro G1
  3. Rota M1
  4. Pelucchi C1
  5. Bonzi R1
  6. Galeone C1
  7. Bravi F1
  8. Johnson KC2
  9. Hu J3
  10. Palli D4
  11. Ferraroni M1
  12. Lopezcarrillo L5
  13. Lunet N6, 7
  14. Ferro A7
  15. Malekzadeh R8
  16. Zaridze D9
  17. Maximovitch D9
  18. Vioque J10, 11
  19. Navarretemunoz EM10, 11
  20. Pakseresht M8, 12, 13
  21. Hernandezramirez RU5, 14
  22. Lopezcervantes M15
  23. Ward M16
  24. Pourfarzi F8, 17
  25. Tsugane S18
  26. Hidaka A18
  27. Zhang ZF19
  28. Kurtz RC20
  29. Lagiou P21, 22
  30. Lagiou A23
  31. Boffetta P24
  32. Boccia S25, 26
  33. Negri E27
  34. La Vecchia C1
Show Affiliations
Authors Affiliations
  1. 1. Department of Clinical Sciences and Community Health, Universita degli Studi di Milano, Milan, Italy
  2. 2. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
  3. 3. Harbin Medical University, Harbin, China
  4. 4. Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
  5. 5. Mexico National Institute of Public Health, Morelos, Mexico
  6. 6. Departamento de Ciencias da Saude Publica e Forenses e Educacao Medica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  7. 7. EPIUnit – Instituto de Saude Publica, Universidade do Porto, Porto, Portugal
  8. 8. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russian Federation
  10. 10. CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain
  11. 11. Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
  12. 12. Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
  13. 13. Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
  14. 14. Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, CT, United States
  15. 15. Direccion General de Planeacion y Desarrollo en Salud, Secretaria de Salud. Coyoacan 1501, Ciudad de Mexico, Mexico
  16. 16. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
  17. 17. Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
  18. 18. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
  19. 19. Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson, Comprehensive Cancer Center, Los Angeles, CA, United States
  20. 20. Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, United States
  21. 21. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  22. 22. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
  23. 23. Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
  24. 24. The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  25. 25. Universita Cattolica del Sacro Cuore, Sezione di Igiene, Istituto di Sanita Pubblica, Rome, Italy
  26. 26. Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Igiene Ospedaliera, Rome, Italy
  27. 27. Department of Biomedical and Clinical Sciences, Universita degli Studi di Milano, Milan, Italy

Source: International Journal of Cancer Published: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. Our study aimed at evaluating and quantifying the association between citrus fruit intake and gastric cancer risk. We conducted a one-stage pooled analysis including 6,340 cases and 14,490 controls from 15 case–control studies from the stomach cancer pooling (StoP) project consortium. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) 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 OR (95% CI) for the highest third was 0.80 (0.73–0.87). The favourable effect of citrus fruits increased progressively until three servings/week and leveled off thereafter. The magnitude of the association was similar between cancer sub-sites and histotypes. The analysis by geographic area showed no association in studies from the Americas. Our data confirm an inverse association between citrus fruits 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. © 2018 UICC
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