Education and gastric cancer risk-An individual participant data meta-analysis in the StoP project consortium.
СтатьяМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Rota Matteo, Alicandro Gianfranco, Pelucchi Claudio, Bonzi Rossella, Bertuccio Paola, Hu Jinfu, Zhang Zuo-Feng, Johnson Kenneth C, Palli Domenico, Ferraroni Monica, Yu Guo-Pei, Galeone Carlotta, López-Carrillo Lizbeth, Muscat Joshua, Lunet Nuno, Ferro Ana, Ye Weimin, Plymoth Amelie, Malekzadeh Reza, Zaridze David, Maximovitch Dmitry, Kogevinas Manolis, Fernández de Larrea Nerea, Vioque Jesus, Navarrete-Muñoz Eva M, Tsugane Shoichiro, Hamada Gerson S, Hidaka Akihisa, Pakseresht Mohammadreza, Wolk Alicja, Håkansson Niclas, Hernández-Ramírez Raúl Ulises, López-Cervantes Malaquias, Ward Mary, Pourfarzi Farhad, Mu Lina, Kurtz Robert C, Lagiou Areti, Lagiou Pagona, Boffetta Paolo, Boccia Stefania, Negri Eva, La Vecchia Carlo
Аннотация
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.