Pickled Food and Risk of Gastric Cancer - A Systematic Review and Meta-Analysis of English and Chinese Literature
A partir d'une revue systématique de la littérature (60 études anglaises et chinoises), cette méta-analyse évalue l'association entre une consommation d'aliments et de légumes macérés dans le vinaigre et le risque de cancer de l'estomac en Asie de l'est
Background: Ecological and experimental studies have suggested an increased risk of gastric cancer in relation to consumption of pickled vegetables in East Asia. Methods: We conducted a meta-analysis of epidemiologic observational studies to evaluate the existing evidence. Searching PubMed, Vip Chinese Periodical and China National Knowledge Infrastructure databases, we found a total of 60 studies, 50 case-control and 10 prospective. We compared gastric cancer risk in pickled vegetable/food users versus non-users (11 studies) or versus those in the lowest reported category of use (49 studies). Pooled results were computed using random-effects models. Results: Among case-control studies, 30 showed significant increased risk and one showed significant decreased risk. Among prospective studies, two showed a significant increased risk but none showed a significant decreased risk. The OR (95% CI) was 1.52 (1.37-1.68) for the overall association, 1.56 (1.39-1.75) for case-control and 1.32 (1.10-1.59) for cohort studies. The OR (95% CI) was 1.89 (1.29-2.77) in Korean, 1.86 (1.61-2.15) in Chinese, and 1.16 (1.04-1.29) in Japanese studies, and 1.14 (0.96-1.35) in studies from other countries. There was high heterogeneity in overall and subgroup analyses. There was little evidence for publication bias. Conclusion: Our results suggest a potential 50% higher risk of gastric cancer associated with intake of pickled vegetables/foods, and perhaps stronger associations in Korea and China. Impact: The results of this study may offer ways to reduce the risk of gastric cancer in highly-populated areas with high incidence of gastric cancer.