Family history and gastric cancer incidence and mortality in Asia: a pooled analysis of more than half a million participants.
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Huang Dan, Song Minkyo, Abe Sarah Krull, Rahman Md Shafiur, Islam Md Rashedul, Saito Eiko, De la Torre Katherine, Sawada Norie, Tamakoshi Akiko, Shu Xiao-Ou, Cai Hui, Hozawa Atsushi, Kanemura Seiki, Kim Jeongseon, Chen Yu, Ito Hidemi, Sugawara Yumi, Park Sue K, Shin Myung-Hee, Hirabayashi Mayo, Kimura Takashi, Gao Yu-Tang, Wen Wanqing, Oze Isao, Shin Aesun, Ahn Yoon-Ok, Ahsan Habibul, Boffetta Paolo, Chia Kee Seng, Matsuo Keitaro, Qiao You-Lin, Rothman Nathaniel, Zheng Wei, Inoue Manami, Kang Daehee
Аннотация
METHODS: We included 12 prospective cohorts with 550,508 participants in the Asia Cohort Consortium. Cox proportional hazard regression was used to estimate study-specific adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between family history of gastric cancer and gastric cancer incidence and mortality, then pooled using random-effects meta-analyses. Stratified analyses were performed for the anatomical subsites and histological subtypes.
RESULTS: During the mean follow-up of 15.6 years, 2258 incident gastric cancers and 5194 gastric cancer deaths occurred. The risk of incident gastric cancer was higher in individuals with a family history of gastric cancer (HR 1.44, 95% CI 1.32-1.58), similarly in males (1.44, 1.31-1.59) and females (1.45, 1.23-1.70). Family history of gastric cancer was associated with both cardia (HR 1.26, 95% CI 1.00-1.60) and non-cardia subsites (1.49, 1.35-1.65), and with intestinal- (1.48, 1.30-1.70) and diffuse-type (1.59, 1.35-1.87) gastric cancer incidence. Positive associations were also found for gastric cancer mortality (HR 1.30, 95% CI 1.19-1.41).
CONCLUSIONS: In this largest prospective study to date on family history and gastric cancer, a familial background of gastric cancer increased the risk of gastric cancer in the Asian population. Targeted education, screening, and intervention in these high-risk groups may reduce the burden of gastric cancer.