title: Cigarette smoking and gastric cancer in the Stomach Cancer Pooling (StoP) Project.
abstract: Tobacco smoking is a known cause of gastric cancer, but several aspects of the association remain imprecisely quantified. We examined the relation between cigarette smoking and the risk of gastric cancer using a uniquely large dataset of 23 epidemiological studies within the 'Stomach cancer Pooling (StoP) Project', including 10 290 cases and 26 145 controls. We estimated summary odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) by pooling study-specific ORs using random-effects models. Compared with never smokers, the ORs were 1.20 (95% CI: 1.09-1.32) for ever, 1.12 (95% CI: 0.99-1.27) for former, and 1.25 (95% CI: 1.11-1.40) for current cigarette smokers. Among current smokers, the risk increased with number of cigarettes per day to reach an OR of 1.32 (95% CI: 1.10-1.58) for smokers of more than 20 cigarettes per day. The risk increased with duration of smoking, to reach an OR of 1.33 (95% CI: 1.14-1.54) for more than 40 years of smoking and decreased with increasing time since stopping cigarette smoking (P for trend<0.01) and became similar to that of never smokers 10 years after stopping. Risks were somewhat higher for cardia than noncardia gastric cancer. Risks were similar when considering only studies with information on Helicobacter pylori infection and comparing all cases to H. pylori+ controls only. This study provides the most precise estimate of the detrimental effect of cigarette smoking on the risk of gastric cancer on the basis of individual data, including the relationship with dose and duration, and the decrease in risk following stopping smoking.
authors: Department of Clinical Sciences and Community Health, University of Milan.
authors: Delphine
authors: D
authors: Praud
authors: Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan.
authors: Matteo
authors: M
authors: Rota
authors: Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan.
authors: Claudio
authors: C
authors: Pelucchi
authors: Department of Clinical Sciences and Community Health, University of Milan.
authors: Paola
authors: P
authors: Bertuccio
authors: Department of Clinical Sciences and Community Health, University of Milan.
authors: Tiziana
authors: T
authors: Rosso
authors: Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan.
authors: Carlotta
authors: C
authors: Galeone
authors: Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California.
authors: Zuo-Feng
authors: ZF
authors: Zhang
authors: Division of Molecular Medicine.
authors: Keitaro
authors: K
authors: Matsuo
authors: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
authors: Hidemi
authors: H
authors: Ito
authors: Harbin Medical University, Harbin.
authors: Jinfu
authors: J
authors: Hu
authors: Department of Epidemiology and Community Health, University of Ottawa, Ottawa, Ontario.
authors: Kenneth C
authors: KC
authors: Johnson
authors: Medical Informatics Center, Peking University, Peking, China.
authors: Guo-Pei
authors: GP
authors: Yu
authors: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence.
authors: Domenico
authors: D
authors: Palli
authors: Department of Clinical Sciences and Community Health, University of Milan.
authors: Monica
authors: M
authors: Ferraroni
authors: The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York.
authors: Joshua
authors: J
authors: Muscat
authors: EPIUnit - Institute of Public Health, University of Porto (ISPUP).|Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
authors: Nuno
authors: N
authors: Lunet
authors: EPIUnit - Institute of Public Health, University of Porto (ISPUP).|Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
authors: Bárbara
authors: B
authors: Peleteiro
authors: Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors: Reza
authors: R
authors: Malekzadeh
authors: Department of Medical Epidemiology and Biostatistics.
authors: Weimin
authors: W
authors: Ye
authors: Department of Medical Epidemiology and Biostatistics.
authors: Huan
authors: H
authors: Song
authors: Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia.
authors: David
authors: D
authors: Zaridze
authors: Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia.
authors: Dmitry
authors: D
authors: Maximovitch
authors: Environmental and Cancer Epidemiology Unit, National Center of Epidemiology, Instituto de Salud Carlos III.|CIBER Epidemiología y Salud Pública (CIBERESP).|Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro, Madrid.
authors: Nuria
authors: N
authors: Aragonés
authors: ISGlobal, Centre for Research in Environmental Epidemiology (CREAL).|IMIM (Hospital del Mar Medical Research Institute).|Universitat Pompeu Fabra (UPF), Barcelona.
authors: Gemma
authors: G
authors: Castaño-Vinyals
authors: ISGlobal, Centre for Research in Environmental Epidemiology (CREAL).|Department of Public Health, Miguel Hernandez University, Campus San Juan, Alicante, Spain.
authors: Jesus
authors: J
authors: Vioque
authors: ISGlobal, Centre for Research in Environmental Epidemiology (CREAL).|Department of Public Health, Miguel Hernandez University, Campus San Juan, Alicante, Spain.
authors: Eva M
authors: EM
authors: Navarrete-Muñoz
authors: Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Canada.|Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.|Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds.
authors: Mohammadreza
authors: M
authors: Pakseresht
authors: Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.|Department of Community Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
authors: Farhad
authors: F
authors: Pourfarzi
authors: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Alicja
authors: A
authors: Wolk
authors: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Nicola
authors: N
authors: Orsini
authors: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Andrea
authors: A
authors: Bellavia
authors: Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors: Niclas
authors: N
authors: Håkansson
authors: Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo.
authors: Lina
authors: L
authors: Mu
authors: Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario 'Agostino Gemelli'.
authors: Roberta
authors: R
authors: Pastorino
authors: Department of Medicine, Memorial Sloan Kettering Cancer Centre.
authors: Robert C
authors: RC
authors: Kurtz
authors: Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.|Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.
authors: Mohammad H
authors: MH
authors: Derakhshan
authors: Department of Public Health and Community Health, School of Health Professions, Athens Technological Educational Institute.
authors: Areti
authors: A
authors: Lagiou
authors: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.|Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors: Pagona
authors: P
authors: Lagiou
authors: The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, New York.
authors: Paolo
authors: P
authors: Boffetta
authors: Section of Hygiene - Institute of Public Health, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario 'Agostino Gemelli'.|ICAHN School of Medicine at Mount Sinai, New York, USA.|IRCCS SAN RAFFAELE PI SANA, Rome, Italy.
authors: Stefania
authors: S
authors: Boccia
authors: Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan.
authors: Eva
authors: E
authors: Negri
authors: Department of Clinical Sciences and Community Health, University of Milan.
authors: Carlo
authors: C
authors: La Vecchia
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D000073865:Cigarette Smoking / Q000009:adverse effects / Q000453:epidemiology*; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D016540:Smoking Cessation; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control