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Meta-Analysis
. 2025 Aug 18;54(5):dyaf160.
doi: 10.1093/ije/dyaf160.

Body mass index and gastric cancer risk: results from the Stomach Cancer Pooling Project Consortium

Roberta Pastorino  1   2 , Denise Pires Marafon  1 , Angelica Valz Gris  1 , Nicolò Lentini  1 , Antonio Cristiano  1 , Nuria Aragonés  3   4 , Vicente Martín  4   5 , David Zaridze  6 , Dmistry Maximovich  6 , Jesus Vioque  4   7 , Sandra Gonzalez-Palacios  4   7 , Reza Malekzadeh  8 , Farhad Pourfarzi  9 , Joshua Muscat  10 , Mary H Ward  11 , Charles S Rabkin  11 , Eva Negri  12 , Rossella Bonzi  13 , Carlo Pelucchi  13 , Paolo Boffetta  12   14 , Maria Costanza Camargo  11 , Maria Paola Curado  15 , Nuno Lunet  16   17   18 , Zuo-Feng Zhang  19 , Carlo La Vecchia  13 , Stefania Boccia  1   2
Affiliations
Meta-Analysis

Body mass index and gastric cancer risk: results from the Stomach Cancer Pooling Project Consortium

Roberta Pastorino et al. Int J Epidemiol. .

Abstract

Background: Body mass index (BMI) has been associated with gastric cancer (GC), though results are conflicting regarding the GC subsites of cardia and non-cardia. This study aims to evaluate the associations between BMI and GC risk, focusing on these distinct anatomical subsites.

Methods: We pooled data from seven case-control studies from the Stomach Cancer Pooling (StoP) Project. Pooled odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) of GC risk across BMI categories (normal weight, overweight, obesity) were calculated by pooling study-specific ORs through random-effects meta-analytic models. The dose-response relationship between BMI and the risk of GC cancer was assessed by using a one-stage mixed-effects logistic regression model. Results were stratified according to cardia and non-cardia GC.

Results: The analysis comprised 1478 GC cases, including 511 cardia and 967 non-cardia cases, and 6671 controls. There was an increased risk of cardia GC among obese patients (OR 1.57, 95% CI 1.20-2.06), while no association was found for non-cardia GC (OR 0.82, 95% CI 0.66-1.01). Restricting the analysis to population-based studies, the association for cardia GC became stronger for obese (OR 1.65, 95% CI 1.09-2.48) and overweight (OR 1.62, 95% CI 1.10-2.39) patients. The dose-response meta-analysis showed an increased risk of cardia GC with increasing BMI values, ranging from a null effect at a BMI of 21.75 to an OR of 2.06 (95% CI 1.22-3.48) for a BMI of ≥40.

Conclusion: Our results indicate an association between higher BMI categories and the risk of cardia GC, whereas no association was found with non-cardia GC.

Keywords: body mass index; cancer prevention; gastric cancer.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Study-specific and adjusted pooled ORs and corresponding 95% CIs of (a) cardia GC risk and (b) non-cardia GC risk for overweight and obese individuals compared with controls, respectively. The number of individuals categorized as underweight (N = 94) is insufficient for the meta-analysis.
Figure 2.
Figure 2.
Dose–response relationship between BMI and cardia GC fitted by using one-stage logistic mixed-effects model with a second-order (powers 2 and 3) fractional polynomial (N = 7099). Solid black line: adjusted OR; dashed black line: 95% CI.
See this image and copyright information in PMC

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