Overview of methodological quality of systematic reviews about gastric cancer risk and protective factors.
OBJECTIVE
A comprehensive overall review of gastric cancer (GC) risk and protective factors is a high priority, so we conducted the present study.


METHODS
Systematic searches in common medical electronic databases along with reference tracking were conducted to include all kinds of systematic reviews (SRs) about GC risk and protective factors. Two authors independently selected studies, extracted data, and evaluated the methodological qualities and the quality of evidence using R-AMSTAR and GRADE approaches.


RESULTS
Beta- carotene below 20 mg/day, fruit, vegetables, non-fermented soy-foods, whole-grain, and dairy product were GC protective factors, while beta-carotene 20 mg/day or above, pickled vegetables, fermented soy-foods, processed meat 30 g/d or above, or salty foods, exposure to alcohol or smoking, occupational exposure to Pb, overweight and obesity, helicobacter pylori infection were GC risk factors. So we suggested screening and treating H. pylori infection, limiting the amount of food containing risk factors (processed meat consumption, beta-carotene, pickled vegetables, fermented soy-foods, salty foods, alcohol), stopping smoking, avoiding excessive weight gain, avoidance of Pb, and increasing the quantity of food containing protective components (fresh fruit and vegetables, non-fermented soy-foods, whole-grain, dairy products).


CONCLUSIONS
The conclusions and recommendations of our study were limited by including SRs with poor methodological bases and low quality of evidence, so that more research applying checklists about assessing the methodological qualities and reporting are needed for the future.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
Lun
L
Li
Xiang-Ji
XJ
Ying
Tian-Tian
TT
Sun
Kang
K
Yi
Hong-Liang
HL
Tian
Rao
R
Sun
Jin-Hui
JH
Tian
Ke-Hu
KH
Yang
D006801:Humans; D015201:Meta-Analysis as Topic; D011379:Prognosis; D012196:Review Literature as Topic; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology* / Q000517:prevention & control*