title: Stage-specific Dietary Factors Associated with the Correa Multistep and Multifactorial Process of Human Gastric Carcinogenesis.
abstract: We assessed how individual dietary intakes act at different points in the chain of sequential stage of the Correa model in an area of Taiwan with high incidence of gastric cancer (GC). Using data on 2,201 participants in a two-stage screening for gastric neoplasia with pepsinogen test, we identified 154 superficial gastritis (SG), 32 atrophic gastritis (AG), 117 intestinal metaplasia (IM), and 22 GC. Effects of individual item-based and construct-based dietary variables aggregated by factor analysis on each stage of gastric neoplasm were assessed. Based on 1,211 subjects with complete information on serological test and dietary questionnaire, SG was associated with positive quartile trend for the intake of meat (trend test P = 0.0014) and the intake of fruits and leafy vegetables (trend test P = 0.0177), but with the negative trend for the intake of shrimp sauce (trend test P = 0.039). A significant positive association was noted between milk and AG (trend test P = 0.014) and IM (P = 0.0087). A positive association between seafood and IM was noted (P = 0.011). Frequent leafy vegetable intake based on individual item was inversely associated with GC (P = 0.0084), whereas frequent intake of meat showed a high positive association (P<0.001). Stage-specific dietary factors underpinning the Correa model were identified.
authors.affiliation: a Institute of Public Health, National Yang-Ming University , Taipei , Taiwan.
authors.forename: Hui-Yin
authors.initials: HY
authors.lastname: Hsiung
authors.affiliation: b Department of Health Industry Management , School of Healthcare Management, Kainan University , Tao-Yuan , Taiwan.
authors.forename: Jean Ching-Yuan
authors.initials: JC
authors.lastname: Fann
authors.affiliation: c School of Oral Hygiene, College of Oral Medicine, Taipei Medical University , Taipei , Taiwan.
authors.forename: Amy Ming-Fang
authors.initials: AM
authors.lastname: Yen
authors.affiliation: c School of Oral Hygiene, College of Oral Medicine, Taipei Medical University , Taipei , Taiwan.
authors.forename: Sam Li-Sheng
authors.initials: SL
authors.lastname: Chen
authors.affiliation: d Department of Health Care Management , College of Management, Chang Gung University , Tao-Yuan , Taiwan.
authors.forename: Sherry Yueh-Hsia
authors.initials: SY
authors.lastname: Chiu
authors.affiliation: e Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University , Taipei , Taiwan.
authors.forename: Tsung-Ho
authors.initials: TH
authors.lastname: Ku
authors.affiliation: f Lienchiang County Government , Matsu , Taiwan.
authors.forename: Tzeng-Ying
authors.initials: TY
authors.lastname: Liu
authors.affiliation: e Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University , Taipei , Taiwan.
authors.forename: Hsiu-Hsi
authors.initials: HH
authors.lastname: Chen
authors.affiliation: a Institute of Public Health, National Yang-Ming University , Taipei , Taiwan.
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Lin
mesh_terms: D000328:Adult; D004032:Diet / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D005756:Gastritis / Q000150:complications / Q000209:etiology; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology* / Q000517:prevention & control; D013624:Taiwan