Education and gastric cancer risk-An individual participant data meta-analysis in the StoP project consortium.
Adult
Aged
Asia
/ epidemiology
Case-Control Studies
Datasets as Topic
Educational Status
Europe
/ epidemiology
Female
Gastric Mucosa
/ microbiology
Health Status Disparities
Helicobacter Infections
/ epidemiology
Helicobacter pylori
/ isolation & purification
Humans
Incidence
Income
/ statistics & numerical data
Male
Middle Aged
North America
/ epidemiology
Risk Assessment
Risk Factors
Stomach Neoplasms
/ epidemiology
Vulnerable Populations
/ statistics & numerical data
education
gastric cancer
income
risk factors
socioeconomic inequalities
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
01 02 2020
01 02 2020
Historique:
received:
07
09
2018
revised:
30
01
2019
accepted:
14
02
2019
pubmed:
29
3
2019
medline:
12
2
2020
entrez:
29
3
2019
Statut:
ppublish
Résumé
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.
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
671-681Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2019 UICC.
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