title: Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies.
abstract: OBJECTIVE
  Systematic reviews of case-control studies evaluating the relationship between dietary salt intake and gastric cancer showed a positive association, however a quantitative analysis of longitudinal cohort studies is lacking. Therefore, we carried out a meta-analysis to assess the association between habitual salt intake and risk of gastric cancer in prospective studies.
  
  
  METHODS
  We performed a systematic search of published articles (1966-2010). Criteria for inclusion were: original articles, prospective adult population studies, assessment of salt intake as baseline exposure and of gastric cancer as outcome, follow-up of at least 4 years, indication of number of participants exposed and events across different salt intake categories.
  
  
  RESULTS
  Seven studies (10 cohorts) met the inclusion criteria (268 718 participants, 1474 events, follow-up 6-15 years). In the pooled analysis, "high" and "moderately high" vs "low" salt intake were both associated with increased risk of gastric cancer (RR = 1.68 [95% C.I. 1.17-2.41], p = 0.005 and respectively 1.41 [1.03-1.93], p = 0.032), with no evidence of publication bias. The association was stronger in the Japanese population and higher consumption of selected salt-rich foods was also associated with greater risk. Meta-regression analyses did not detect specific sources of heterogeneity.
  
  
  CONCLUSIONS
  Dietary salt intake was directly associated with risk of gastric cancer in prospective population studies, with progressively increasing risk across consumption levels.
authors.affiliation: Department of Clinical and Experimental Medicine, ESH - Excellence Center of Hypertension, Federico II University Medical School, via S Pansini 5, 80131 Naples, Italy.
authors.forename: Lanfranco
authors.initials: L
authors.lastname: D'Elia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.forename: Renato
authors.initials: R
authors.lastname: Ippolito
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Cappuccio
authors.forename: Pasquale
authors.initials: P
authors.lastname: Strazzullo
mesh_terms: D004032:Diet; D005247:Feeding Behavior; D006801:Humans; D012307:Risk Factors; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000209:etiology / Q000503:physiopathology*
chemical_list: D017673:Sodium Chloride, Dietary