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Education and Gastric Cancer Risk—An Individual Participant Data Meta-Analysis in the Stop Project Consortium Publisher Pubmed



Rota M1, 2 ; Alicandro G2, 3 ; Pelucchi C2 ; Bonzi R2 ; Bertuccio P2, 4 ; Hu J5 ; Zhang ZF6 ; Johnson KC7 ; Palli D8 ; Ferraroni M2 ; Yu GP9 ; Galeone C2 ; Lopezcarrillo L10 ; Muscat J11 Show All Authors
Authors
  1. Rota M1, 2
  2. Alicandro G2, 3
  3. Pelucchi C2
  4. Bonzi R2
  5. Bertuccio P2, 4
  6. Hu J5
  7. Zhang ZF6
  8. Johnson KC7
  9. Palli D8
  10. Ferraroni M2
  11. Yu GP9
  12. Galeone C2
  13. Lopezcarrillo L10
  14. Muscat J11
  15. Lunet N12, 13
  16. Ferro A13
  17. Ye W14
  18. Plymoth A14
  19. Malekzadeh R15
  20. Zaridze D16
  21. Maximovitch D16
  22. Kogevinas M17, 18, 19, 20
  23. Fernandez De Larrea N17, 21
  24. Vioque J17, 22
  25. Navarretemunoz EM17, 22
  26. Tsugane S23
  27. Hamada GS24
  28. Hidaka A23
  29. Pakseresht M15, 25, 26
  30. Wolk A27
  31. Hakansson N27
  32. Hernandezramirez RU10, 28
  33. Lopezcervantes M29
  34. Ward M30
  35. Pourfarzi F15, 31
  36. Mu L32
  37. Kurtz RC33
  38. Lagiou A34
  39. Lagiou P35, 36
  40. Boffetta P37, 38
  41. Boccia S39, 40
  42. Negri E4
  43. La Vecchia C2
Show Affiliations
Authors Affiliations
  1. 1. Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
  2. 2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
  3. 3. Italian National Institute of Statistics, Rome, Italy
  4. 4. Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
  5. 5. Harbin Medical University, Harbin, China
  6. 6. Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, United States
  7. 7. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
  8. 8. Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy
  9. 9. Medical Informatics Center, Peking University, Peking, China
  10. 10. Mexico National Institute of Public Health, Morelos, Mexico
  11. 11. Department of Public Health Sciences, Tobacco Center of Regulatory Science, Penn Sylvania State University College of Medicine, Hershey, PA, United States
  12. 12. Departamento de Ciencias da Saude Publica e Forenses e Educacao Medica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  13. 13. EPIUnit – Instituto de Saude Publica, Universidade do Porto, Porto, Portugal
  14. 14. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  15. 15. Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  16. 16. Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russian Federation
  17. 17. CIBER Epidemiologia y Salud Publica (CIBERESP), Madrid, Spain
  18. 18. ISGlobal, Barcelona, Spain
  19. 19. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
  20. 20. Universitat Pompeu Fabra (UPF), Barcelona, Spain
  21. 21. Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
  22. 22. Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Alicante, Spain
  23. 23. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
  24. 24. Nikkei Disease Prevention Center, Sao Paulo, Brazil
  25. 25. Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
  26. 26. Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, United Kingdom
  27. 27. Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  28. 28. Department of Biostatistics, Yale School of Public Health, Yale School of Medicine, New Haven, CT, United States
  29. 29. Direccion General de Planeacion y Desarrollo en Salud, Secretaria de Salud, Benito Juarez, Mexico
  30. 30. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
  31. 31. Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
  32. 32. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
  33. 33. Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, United States
  34. 34. Department of Public and Community Health, School of Health Sciences, University of West Attica, Egaleo, Greece
  35. 35. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  36. 36. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
  37. 37. The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  38. 38. Department of Medical and Surgical Sciences, University of Bologna, Italy
  39. 39. Sezione di Igiene, Istituto di Sanita Pubblica, Universita Cattolica del Sacro Cuore, Roma, Italy
  40. 40. Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italy

Source: International Journal of Cancer Published:2020


Abstract

Low socioeconomic position (SEP) is a strong risk factor for incidence and premature mortality from several cancers. Our study aimed at quantifying the association between SEP and gastric cancer (GC) risk through an individual participant data meta-analysis within the “Stomach cancer Pooling (StoP) Project”. Educational level and household income were used as proxies for the SEP. We estimated pooled odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) across levels of education and household income by pooling study-specific ORs through random-effects meta-analytic models. The relative index of inequality (RII) was also computed. A total of 9,773 GC cases and 24,373 controls from 25 studies from Europe, Asia and America were included. The pooled OR for the highest compared to the lowest level of education was 0.60 (95% CI, 0.44–0.84), while the pooled RII was 0.45 (95% CI, 0.29–0.69). A strong inverse association was observed both for noncardia (OR 0.39, 95% CI, 0.22–0.70) and cardia GC (OR 0.47, 95% CI, 0.22–0.99). The relation was stronger among H. pylori negative subjects (RII 0.14, 95% CI, 0.04–0.48) as compared to H. pylori positive ones (RII 0.29, 95% CI, 0.10–0.84), in the absence of a significant interaction (p = 0.28). The highest household income category showed a pooled OR of 0.65 (95% CI, 0.48–0.89), while the corresponding RII was 0.40 (95% CI, 0.22–0.72). Our collaborative pooled-analysis showed a strong inverse relationship between SEP indicators and GC risk. Our data call for public health interventions to reduce GC risk among the more vulnerable groups of the population. © 2019 UICC
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15. The Stomach Cancer Pooling (Stop) Project: Study Design and Presentation, European Journal of Cancer Prevention (2015)
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