Childhood and Adulthood Risk Factors of Gastric Cancer: A Hospital-Based Case-Control Study in Iran

Maryam  Hadji; Fatemeh  Toorang; Neda  Amni; Mahshid  Mortazavi; Fatemeh  Mirfazli; Sourabh  Zamani; Elham  Kamlai-Hakim; Mahsa  Fithian; Bahareh  Sasanfar; Rana  Daroudi; Fatemeh  Shakeri; Farin  Kamangar; Kazem Zendehdel

doi:10.18502/bccr.v16i3.19693

Maryam Hadji A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio 70150, Finland
Fatemeh Toorang Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Neda Amni Northwell Health, North Shore/ Long Island Jewish, Department of Surgical Oncology, NYC, USA
Mahshid Mortazavi Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Fatemeh Mirfazli Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Sourabh Zamani Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Elham Kamlai-Hakim Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Mahsa Fithian Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Bahareh Sasanfar Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Rana Daroudi Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Fatemeh Shakeri Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran
Farin Kamangar Department of Biology, School of Computer, Mathematics, and Natural Sciences, Morgan State University, Baltimore, MD, USA
Kazem Zendehdel Cancer Research Center, Cancer Institute, Tehran University Medical of Sciences, Tehran, I.R. Iran

DOI: https://doi.org/10.18502/bccr.v16i3.19693

Keywords: Gastric Cancer; Risk Factors; Iran

Abstract

Background: Gastric cancer (GC) is the most common cancer among Iranian men.This study aimed to investigate the association between early and late lifestyle riskfactors and GC among the Iranian population.

Method: A hospital-based case-control study recruited GC patients from the Can-cer Institute in 2010-2012. Controls were healthy visitors to be frequency-matchedbased on sex, age, and residential place, and were recruited from the non-oncologywards. We collected exposure to various established risk factors before the diagnosisin patients and prior to the interview in controls. Additionally, we obtained infor-mation on socioeconomic factors during childhood. Logistic regression models wereemployed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) forvarious potential risk factors.

Results: The study included a total of 210 GC patients and 210 controls. The averageage of cases was 59.9 years, and controls were 56.7 years. Participants with a familyhistory of GC had a 4-fold higher risk of GC than those without a family history(OR=4.1, 95% CI: 1.7, 9.6). We observed an inverse association between GC witheducation (P-value for trend =0.003). Individuals reported coffee consumption hada lower risk of GC (OR=0.5, 95% CI: 0.3, 0.8) as compared to non-coffee users. Thestudy found that individuals with high intake of fruit (OR=0.6, 95% CI: 0.3, 1.3) andmedium (OR=0.5, 95% CI: 0.3, 1.0) and high (OR=0.3, 95% CI: 0.1, 0.6) intake ofvegetables had lower odds of GC, while higher consumption of red meat (OR=5.3,95% CI: 2.8, 10.2) had higher odds of GC. Analysis of factors related to the childhoodperiod showed that lack of access to tap water increased odds of GC compared to ac-cess to tap water (OR: 2.9, 95% CI: 1.3, 6.7). We did not observe any significant associ-ations between h. pylori infection, opium use, waterpipe smoking, cigarette smoking,alcohol consumption, BMI, and other early life risk factors, and the risk of GC.

Conclusion: The occurrence of GC is influenced by several factors, including familyhistory of GC, dietary habits, and socioeconomic status (SES) during both childhoodand adulthood.