Nitrosamine and related food intake and gastric and oesophageal cancer risk: a systematic review of the epidemiological evidence.
OBJECTIVE
To study the association between nitrite and nitrosamine intake and gastric cancer (GC), between meat and processed meat intake, GC and oesophageal cancer (OC), and between preserved fish, vegetable and smoked food intake and GC.


METHODS
In this article we reviewed all the published cohort and case-control studies from 1985-2005, and analyzed the relationship between nitrosamine and nitrite intake and the most important related food intake (meat and processed meat, preserved vegetables and fish, smoked foods and beer drinking) and GC or OC risk. Sixty-one studies, 11 cohorts and 50 case-control studies were included.


RESULTS
Evidence from case-control studies supported an association between nitrite and nitrosamine intake with GC but evidence was insufficient in relation to OC. A high proportion of case-control studies found a positive association with meat intake for both tumours (11 of 16 studies on GC and 11 of 18 studies on OC). A relatively large number of case-control studies showed quite consistent results supporting a positive association between processed meat intake and GC and OC risk (10 of 14 studies on GC and 8 of 9 studies on OC). Almost all the case-control studies found a positive and significant association between preserved fish, vegetable and smoked food intake and GC. The evidence regarding OC was more limited. Overall the evidence from cohort studies was insufficient or more inconsistent than that from case-control studies.


CONCLUSIONS
The available evidence supports a positive association between nitrite and nitrosamine intake and GC, between meat and processed meat intake and GC and OC, and between preserved fish, vegetable and smoked food intake and GC, but is not conclusive.
Jakszyn
Paula
P
Unit of Nutrition, Environment and Cancer, Department of Epidemiology and Cancer Registry, Institut Català d' Oncologia, (ICO-IDIBELL), L'Hospitalet de LLobregrat (08907), Barcelona, Spain. paujak@ico.scs.es
Gonzalez
Carlos-Alberto
CA
D016022:Case-Control Studies; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D005396:Fish Products / Q000032:analysis; D005519:Food Preservation / Q000379:methods; D006801:Humans; D008461:Meat Products / Q000032:analysis; D009566:Nitrates / Q000009:adverse effects* / Q000032:analysis; D009602:Nitrosamines / Q000009:adverse effects* / Q000032:analysis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D014675:Vegetables / Q000737:chemistry
D009566:Nitrates; D009602:Nitrosamines