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Japanese Journal of Clinical Oncology 2006 36(12):800-807; doi:10.1093/jjco/hyl112
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© 2007 Foundation for Promotion of Cancer Research

Tobacco Smoking and Gastric Cancer Risk: An Evaluation Based on a Systematic Review of Epidemiologic Evidence among the Japanese Population

Yoshikazu Nishino1,, Manami Inoue2, Ichiro Tsuji3, Kenji Wakai4, Chisato Nagata5, Tetsuya Mizoue6, Keitaro Tanaka7, Shoichiro Tsugane2,* for the Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan

1 Division of Epidemiology, Miyagi Cancer Center Research Institute, Natori, Miyagi
2 Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo
3 Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai
4 Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya
5 Department of Epidemiology and Preventive Medicine, Gifu University School of Medicine, Gifu
6 Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
7 Department of Preventive Medicine, Saga Medical School, Faculty of Medicine, Saga University, Saga, Japan

For reprints and all correspondence: Yoshikazu Nishino, Division of Epidemiology, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori, Miyagi, 981-1293, Japan. E-mail: nishino-yo539{at}pref.miyagi.jp

Received May 28, 2006; accepted August 5, 2006

BACKGROUND: We evaluated the association between tobacco smoking and gastric cancer risk among the Japanese population based on a systematic review of epidemiologic evidence.

METHODS: Original data were collected by searches of MEDLINE using PubMed, complemented with manual searches. Evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility, as evaluated previously by the International Agency for Research on Cancer.

RESULTS: Ten cohort studies and 16 case-control studies were identified. In men, most studies reported moderate or strong positive associations between smoking and gastric cancer. In women, the positive association was weaker than in men. Of eight studies (three cohort studies and five case–case control studies), two cohort and three case control studies reported a weakly to strongly increased risk of gastric cancer. The summary relative risk for current smokers was estimated to be 1.56 (95% confidence intervals 1.36–1.80), 1.79 (1.51–2.12), 1.22 (1.07–1.38) for the total population, men and women, respectively.

CONCLUSION: We conclude that there is convincing evidence that tobacco smoking moderately increases the risk of gastric cancer among the Japanese population.

Key Words: systematic review • epidemiology • tobacco smoking • stomach cancer • Japanese

* Research group members are listed after the Acknowledgments.


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