The mediating role of combined lifestyle factors on the relationship between education and gastric cancer in the Stomach cancer Pooling (StoP) Project

被引：8

作者：

Alicandro, Gianfranco ^{[1
,2
]}

Bertuccio, Paola ^{[3
,4
]}

Collatuzzo, Giulia ^{[5
]}

Pelucchi, Claudio ^{[4
]}

Bonzi, Rossella ^{[4
]}

Liao, Linda M. ^{[6
]}

Rabkin, Charles S. ^{[6
]}

Sinha, Rashmi ^{[6
]}

Negri, Eva ^{[4
,5
,7
]}

Dalmartello, Michela ^{[4
]}

Zaridze, David ^{[8
]}

Maximovich, Dmitry ^{[8
]}

Vioque, Jesus ^{[9
,10
]}

Garcia de la Hera, Manoli ^{[9
,10
]}

Tsugane, Shoichiro ^{[11
,12
]}

Hidaka, Akihisa ^{[11
]}

Hamada, Gerson Shigueaki ^{[13
]}

Lopez-Carrillo, Lizbeth ^{[14
]}

Hernandez-Ramirez, Raul Ulises ^{[15
]}

Malekzadeh, Reza ^{[16
]}

Pourfarzi, Farhad ^{[17
]}

Zhang, Zuo-Feng ^{[18
]}

Kurtz, Robert C. ^{[19
]}

Camargo, M. Constanza ^{[6
]}

Curado, Maria Paula ^{[20
]}

Lunet, Nuno ^{[21
,22
,23
]}

Boffetta, Paolo ^{[5
,24
]}

La Vecchia, Carlo ^{[4
]}

机构：

[1] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[2] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Cyst Fibrosis Ctr, Milan, Italy

[3] Univ Pavia, Dept Publ Hlth Expt & Forens Med, Pavia, Italy

[4] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy

[5] Univ Bologna, Dept Med & Surg Sci, Bologna, Italy

[6] NCI, Div Canc Epidemiol & Genet, NIH, Rockville, MD USA

[7] Pegaso Online Univ, Naples, Italy

[8] NN Blokhin Natl Med Res Ctr Oncol, Dept Clin Epidemiol, Moscow, Russia

[9] Univ Miguel Hernandez ISABIAL UMH, Inst Invest Sanitaria & Biomed Alicante, Alicante, Spain

[10] Consortium Biomed Res Epidemiol & Publ Hlth CIBER, Madrid, Spain

[11] Natl Canc Ctr, Ctr Publ Hlth Sci, Epidemiol & Prevent Grp, Tokyo, Japan

[12] Natl Inst Hlth & Nutr, Natl Inst Biomed Innovat Hlth & Nutr, Tokyo, Japan

[13] Nikkei Dis Prevent Ctr, Sao Paulo, SP, Brazil

[14] Mexico Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico

[15] Yale Sch Publ Hlth, Yale Sch Med, Dept Biostat, New Haven, CT USA

[16] Univ Tehran Med Sci, Digest Oncol Res Ctr, Digest Dis Res Inst, Tehran, Iran

[17] Ardabil Univ Med Sci, Digest Dis Res Ctr, Ardebil, Iran

[18] UCLA Fielding Sch Publ Hlth & Jonsson Comprehens, Dept Epidemiol, Los Angeles, CA USA

[19] Mem Sloan Kettering Canc Ctr, Dept Med, 1275 York Ave, New York, NY 10021 USA

[20] Ctr Int Pesquisa, AC Camargo Canc Ctr, Sao Paulo, Brazil

[21] Univ Porto, EPIUnit, Inst Saude Publ, Porto, Portugal

[22] Lab Invest Integrat & Translac Saude Populac ITR, Porto, Portugal

[23] Univ Porto, Dept Ciencias Saude Publ & Forenses & Educ Med, Fac Med, Porto, Portugal

[24] SUNY Stony Brook, Stony Brook Canc Ctr, Stony Brook, NY USA

来源：

BRITISH JOURNAL OF CANCER | 2022年 / 127卷 / 05期

关键词：

HELICOBACTER-PYLORI INFECTION; RISK-FACTORS; DIETARY-INTAKE; OCCUPATIONAL EXPOSURES; JAPANESE BRAZILIANS; ALCOHOL-CONSUMPTION; METAANALYSIS; MORTALITY; ADENOCARCINOMA; BEHAVIORS;

D O I：

10.1038/s41416-022-01857-9

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background The causal pathway between high education and reduced risk of gastric cancer (GC) has not been explained. The study aimed at evaluating the mediating role of lifestyle factors on the relationship between education and GC Methods Ten studies with complete data on education and five lifestyle factors (smoking, alcohol drinking, fruit and vegetable intake, processed meat intake and salt consumption) were selected from a consortium of studies on GC including 4349 GC cases and 8441 controls. We created an a priori score based on the five lifestyle factors, and we carried out a counterfactual-based mediation analysis to decompose the total effect of education on GC into natural direct effect and natural indirect effect mediated by the combined lifestyle factors. Effects were expressed as odds ratios (ORs) with a low level of education as the reference category. Results The natural direct and indirect effects of high versus low education were 0.69 (95% CI: 0.62-0.77) and 0.96 (95% CI: 0.95-0.97), respectively, corresponding to a mediated percentage of 10.1% (95% CI: 7.1-15.4%). The mediation effect was limited to men. Conclusions The mediation effect of the combined lifestyle factors on the relationship between education and GC is modest. Other potential pathways explaining that relationship warrants further investigation.

引用

页码：855 / 862

页数：8

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