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Diet and gastric cancer risk: an umbrella review of systematic reviews and meta-analyses of prospective cohort studies

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机构: [1]Guangzhou Univ Chinese Med, Sch Clin Med 2, Guangzhou, Peoples R China [2]Guangzhou Univ Chinese Med, State Key Lab Dampness Syndrome Chinese Med, Affiliated Hosp 2, 36 Yuexiu Dist, Guangzhou 510000, Guangdong, Peoples R China [3]Guangzhou Univ Chinese Med, Guangdong Prov Key Lab Clin Res Tradit Chinese Me, Affiliated Hosp 2, Guangzhou, Peoples R China [4]Heilongjiang Univ Tradit Chinese Med, Clin Med Coll 1, Harbin, Peoples R China
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关键词: Diet Gastric cancer Meta-analysis Evidence Umbrella review

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Background Several systematic reviews and meta-analyses evaluated the associations between dietary factors and the incidence of gastric cancer (GC). Objectives To evaluate the strength and validity of existing evidence, we conducted an umbrella review of published systematic reviews and meta-analyses that investigated the association between diets and GC incidence. Methods We searched the PubMed, Embase, and Cochrane databases for systematic reviews and meta-analyses of prospective cohort studies investigating the association between dietary factors and GC risk. For each association, we recalculated the adjusted summary estimates with their 95% confidence interval (CI) and 95% prediction interval (PI) using a random-effects model. We used the I-2 statistic and Egger's test to assess heterogeneity and small-study effects, respectively. We also assessed the methodological quality of each study and the quality of evidence. Results Finally, we identified 16 meta-analyses that described 57 associations in this umbrella review. Of the 57 associations, eight were statistically significant using random-effects, thirteen demonstrated substantial heterogeneity between studies (I-2 > 50%), and three found small-study effects. The methodological quality of meta-analyses was classified as critically low for two (13%), low for thirteen (81%), and only one (6%) was rated as high confidence. Quality of evidence was rated high for a positive association for GC incidence with a higher intake of total alcohol (RR = 1.19, 95% CI 1.06-1.34) and moderate-quality evidence to support that increased processed meat consumption can increase GC incidence. Three associations (total fruit, vitamin E, and carotenoids) were determined to be supported by low-quality evidence, and two (pickled vegetables/foods and citrus fruit) were supported by very low-quality. Conclusions Our findings support the dietary recommendations for preventative GC, emphasizing lower intake of alcohol and foods preserved by salting. New evidence suggests a possible role for total fruit, citrus fruit, carotenoids, and vitamin E. More research is needed on diets with lower quality evidence. Registration number CRD42021255115.

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基金编号: YN2018ZD02 2017B030314166 81673845 2019A1515010638 SZ2020ZZ03 2020B1111100010

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
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大类 | 4 区 医学
小类 | 4 区 肿瘤学
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Q2 ONCOLOGY
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第一作者机构: [1]Guangzhou Univ Chinese Med, Sch Clin Med 2, Guangzhou, Peoples R China
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通讯机构: [2]Guangzhou Univ Chinese Med, State Key Lab Dampness Syndrome Chinese Med, Affiliated Hosp 2, 36 Yuexiu Dist, Guangzhou 510000, Guangdong, Peoples R China [3]Guangzhou Univ Chinese Med, Guangdong Prov Key Lab Clin Res Tradit Chinese Me, Affiliated Hosp 2, Guangzhou, Peoples R China
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