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Open Access Highly Accessed Research article

Nutrition deficiency increases the risk of stomach cancer mortality

Qing Da Li1, Hao Li2*, Fu Ji Li1, Mei Shu Wang3, Zhuo Jian Li4, Jing Han5, Qing Hui Li6, Xiang Ji Ma7 and Da Nan Wang8

Author affiliations

1 Department of Medicine, Qilu Hospital of Shandong University, Jinan, China

2 Tumor Center, Qilu Hospital of Shandong University, Jinan, China

3 Department of Epidemiology, College of Public Health of Shandong University, Jinan, China

4 Center of Disease Control and Prevention of Jinan, Jinan, China

5 Department of Environmental Medicine, School of Medicine New York University, New York, USA

6 Department of Epidemiology, Institute of Basic Medicine of Shandong Academy of Medical Sciences, Jinan, China

7 Center of Disease Control and Prevention of Shandong Province, Jinan, China

8 Center of Disease Control and Prevention of Zhaoyuan, Zhaoyuan, China

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Citation and License

BMC Cancer 2012, 12:315  doi:10.1186/1471-2407-12-315

Published: 28 July 2012

Abstract

Background

The purpose of the study is to determine whether exposure to malnutrition during early life is associated with increased risk of stomach cancer in later life.

Methods

The design protocol included analyzing the trend of gastric cancer mortality and nutrition and evaluating the association between nutrient deficiency in early life and the risk of gastric cancer by hierarchical age–period–birth cohort (APC) analysis using general log-linear Poisson models and to compare the difference between birth cohorts who were exposed to the 1959–1961 Chinese famine and those who were not exposed to the famine. Data on stomach cancer mortality from 1970 to 2009 and the dietary patterns from 1955 to 1985 which included the 1959–1961 Chinese famine period in the Zhaoyuan County population were obtained. The nutrition information was collected 15 years prior to the mortality data as based on the latest reference of disease incubation.

Results

APC analysis revealed that severe nutrition deficiency during early life may increase the risk of stomach cancer. Compared with the 1960–1964 birth cohort, the risk for stomach cancer in all birth cohorts from 1900 to 1959 significantly increased; compared with the 1970–1974 cohort, the risk for stomach cancer in the 1975–1979 cohort significantly increased, whereas the others had a steadily decreased risk; compared with 85–89 age group in the 2005–2009 death survey, the ORs decreased with younger age and reached significant levels for the 50–54 age group after adjusting the confounding factors. The 1930 to 1964 group (exposed to famine) had a higher mortality rate than the 1965 to 1999 group (not exposed to famine). For males, the relative risk (RR) was 2.39 and the 95% confidence interval (CI) was 1.51 to 3.77. For females, RR was 1.64 and 95% CI was 1.02 to 2.62.

Conclusion

The results of the present study suggested that prolonged malnutrition during early life may increase the risk of stomach cancer mortality in later life.

Keywords:
Nutritive deficiency; Stomach Cancer; Mortality; Famine exposure