TY - JOUR
T1 - Education and gastric cancer risk—An individual participant data meta-analysis in the StoP project consortium
AU - Rota, Matteo
AU - Alicandro, Gianfranco
AU - Pelucchi, Claudio
AU - Bonzi, Rossella
AU - Bertuccio, Paola
AU - Hu, Jinfu
AU - Zhang, Zuo Feng
AU - Johnson, Kenneth C.
AU - Palli, Domenico
AU - Ferraroni, Monica
AU - Yu, Guo Pei
AU - Galeone, Carlotta
AU - López-Carrillo, Lizbeth
AU - Muscat, Joshua
AU - Lunet, Nuno
AU - Ferro, Ana
AU - Ye, Weimin
AU - Plymoth, Amelie
AU - Malekzadeh, Reza
AU - Zaridze, David
AU - Maximovitch, Dmitry
AU - Kogevinas, Manolis
AU - Fernández de Larrea, Nerea
AU - Vioque, Jesus
AU - Navarrete-Muñoz, Eva M.
AU - Tsugane, Shoichiro
AU - Hamada, Gerson S.
AU - Hidaka, Akihisa
AU - Pakseresht, Mohammadreza
AU - Wolk, Alicja
AU - Håkansson, Niclas
AU - Hernández-Ramírez, Raúl Ulises
AU - López-Cervantes, Malaquias
AU - Ward, Mary
AU - Pourfarzi, Farhad
AU - Mu, Lina
AU - Kurtz, Robert C.
AU - Lagiou, Areti
AU - Lagiou, Pagona
AU - Boffetta, Paolo
AU - Boccia, Stefania
AU - Negri, Eva
AU - La Vecchia, Carlo
N1 - Publisher Copyright:
© 2019 UICC
PY - 2020/2/1
Y1 - 2020/2/1
N2 - 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.
AB - 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.
KW - education
KW - gastric cancer
KW - income
KW - risk factors
KW - socioeconomic inequalities
UR - https://www.scopus.com/pages/publications/85064162932
U2 - 10.1002/ijc.32298
DO - 10.1002/ijc.32298
M3 - Article
C2 - 30919464
AN - SCOPUS:85064162932
SN - 0020-7136
VL - 146
SP - 671
EP - 681
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 3
ER -