The association between diabetes and gastric cancer: results from the Stomach Cancer Pooling Project Consortium

Bashir Dabo¹, Claudio Pelucchi², Matteo Rota³, Harshonnati Jain⁴, Paola Bertuccio⁵, Rossella Bonzi², Domenico Palli⁶, Monica Ferraroni², Zuo-Feng Zhang⁷, Aurora Sanchez-Anguiano¹, Yen Thi-Hai Pham⁸, Chi Thi-Du Tran⁹, Anh Gia Pham¹⁰, Guo-Pei Yu¹¹, Tin C Nguyen¹², Joshua Muscat¹³, Shoichiro Tsugane¹⁴, Akihisa Hidaka¹⁴, Gerson S Hamada¹⁵, David Zaridze¹⁶, Dmitry Maximovitch¹⁶, Manolis Kogevinas^{17

18

19

20}, Nerea Fernàndez de Larrea^{17

21}, Stefania Boccia^{22

23}, Roberta Pastorino²², Robert C Kurtz²⁴, Areti Lagiou²⁵, Pagona Lagiou^{26

27}, Jesus Vioque^{17

28}, M Constanza Camargo²⁹, Maria Paula Curado³⁰, Nuno Lunet^{31

32}, Paolo Boffetta^{33

34}, Eva Negri⁵, Carlo La Vecchia², Hung N Luu^{35

36}

Affiliations

¹ College of Public Health, University of South Florida, Tampa, Florida, USA.
² Department of Clinical Sciences and Community Health, University of Milan, Milan.
³ Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
⁴ Department of Information Systems and Decision Sciences (ISDS), Muma College of Business, University of South Florida, Tampa, Florida, USA.
⁵ Department of Biomedical and Clinical Sciences, University of Milan, Milan.
⁶ Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.
⁷ Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA.
⁸ Department of Rehabilitation, Vinmec Hospital Times City, Vinmec Healthcare System.
⁹ Vietnam Colorectal Cancer and Polyps Research Program, Vinmec Healthcare System.
¹⁰ Department of Surgical Oncology, Viet-Duc University Hospital, Hanoi, Vietnam.
¹¹ Medical Informatics Center, Peking University, Peking, China.
¹² Department of Computer Sciences and Engineering, University of Nevada-Reno, Reno, Nevada.
¹³ Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
¹⁴ Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan.
¹⁵ Nikkei Disease Prevention Center, São Paulo, Brazil.
¹⁶ Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia.
¹⁷ CIBER Epidemiología y Salud Pública (CIBERESP), Madrid.
¹⁸ ISGlobal.
¹⁹ IMIM (Hospital del Mar Medical Research Institute).
²⁰ Universitat Pompeu Fabra (UPF), Barcelona.
²¹ Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain.
²² Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore.
²³ Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.
²⁴ Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA.
²⁵ Department of Public and Community Health, School of Health Sciences, University of West Attica.
²⁶ Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
²⁷ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
²⁸ Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Campus San Juan, Alicante, Spain.
²⁹ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
³⁰ Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil.
³¹ Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro.
³² EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.
³³ Stony Brook Cancer Center, Stony Brook University, New York, New York, USA.
³⁴ Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
³⁵ UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh.
³⁶ Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

PMID: 34183534
PMCID: PMC8709871
DOI: 10.1097/CEJ.0000000000000703

Meta-Analysis

The association between diabetes and gastric cancer: results from the Stomach Cancer Pooling Project Consortium

Bashir Dabo et al. Eur J Cancer Prev. 2022.

. 2022 May 1;31(3):260-269.

doi: 10.1097/CEJ.0000000000000703.

Authors

Affiliations

¹ College of Public Health, University of South Florida, Tampa, Florida, USA.
² Department of Clinical Sciences and Community Health, University of Milan, Milan.
³ Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
⁴ Department of Information Systems and Decision Sciences (ISDS), Muma College of Business, University of South Florida, Tampa, Florida, USA.
⁵ Department of Biomedical and Clinical Sciences, University of Milan, Milan.
⁶ Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, ISPRO, Florence, Italy.
⁷ Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA.
⁸ Department of Rehabilitation, Vinmec Hospital Times City, Vinmec Healthcare System.
⁹ Vietnam Colorectal Cancer and Polyps Research Program, Vinmec Healthcare System.
¹⁰ Department of Surgical Oncology, Viet-Duc University Hospital, Hanoi, Vietnam.
¹¹ Medical Informatics Center, Peking University, Peking, China.
¹² Department of Computer Sciences and Engineering, University of Nevada-Reno, Reno, Nevada.
¹³ Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
¹⁴ Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan.
¹⁵ Nikkei Disease Prevention Center, São Paulo, Brazil.
¹⁶ Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia.
¹⁷ CIBER Epidemiología y Salud Pública (CIBERESP), Madrid.
¹⁸ ISGlobal.
¹⁹ IMIM (Hospital del Mar Medical Research Institute).
²⁰ Universitat Pompeu Fabra (UPF), Barcelona.
²¹ Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain.
²² Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore.
²³ Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.
²⁴ Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York, NY, USA.
²⁵ Department of Public and Community Health, School of Health Sciences, University of West Attica.
²⁶ Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
²⁷ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
²⁸ Department of Public Health, Miguel Hernandez University, FISABIO-ISABIAL, Campus San Juan, Alicante, Spain.
²⁹ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
³⁰ Centro Internacional de Pesquisa, A. C. Camargo Cancer Center, São Paulo, Brazil.
³¹ Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro.
³² EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal.
³³ Stony Brook Cancer Center, Stony Brook University, New York, New York, USA.
³⁴ Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
³⁵ UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh.
³⁶ Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

PMID: 34183534
PMCID: PMC8709871
DOI: 10.1097/CEJ.0000000000000703

Abstract

Background: Prior epidemiologic studies on the association between diabetes and gastric cancer risk provided inconclusive findings, while traditional, aggregate data meta-analyses were characterized by high between-study heterogeneity.

Objective: To investigate the association between type 2 diabetes and gastric cancer using data from the 'Stomach Cancer Pooling (StoP) Project', an international consortium of more than 30 case-control and nested case-control studies, which is large and provides harmonized definition of participants' characteristics across individual studies. The data have the potential to minimize between-study heterogeneity and provide greater statistical power for subgroup analysis.

Methods: We included 5592 gastric cancer cases and 12 477 controls from 14 studies from Europe, Asia, North America, and South America in a two-stage individual-participant data meta-analysis. Random-effect models were used to estimate summary odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) by pooling study-specific ORs.

Results: We did not find an overall association between diabetes and gastric cancer (pooled OR = 1.01, 95% CI, 0.94-1.07). However, the risk of cardia gastric cancer was significantly higher among individuals with type 2 diabetes (OR = 1.16, 95% CI, 1.02-1.33). There was no association between diabetes and gastric cancer risk in strata of Helicobacter pylori infection serostatus, age, sex, BMI, smoking status, alcohol consumption, fruit/vegetable intake, gastric cancer histologic type, and source of controls.

Conclusion: This study provides additional evidence that diabetes is unrelated to gastric cancer overall but may be associated with excess cardia gastric cancer risk.

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Conflict of interest statement

There are no conflicts of interest.

Figures

**Fig. 1**
Study-specific and pooled odds ratios and their respective 95% confidence intervals for the association between diabetes and gastric cancer risk in the Stomach Cancer Pooling (StoP) Project Consortium. CI, confidence interval.

See this image and copyright information in PMC

References

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The association between diabetes and gastric cancer: results from the Stomach Cancer Pooling Project Consortium

Affiliations

The association between diabetes and gastric cancer: results from the Stomach Cancer Pooling Project Consortium

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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