Habitual salt intake and risk of gastric cancer: A meta-analysis of prospective studies

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 31; no. 4; pp. 489 - 498
• Main Authors: D’Elia, Lanfranco, Rossi, Giovanni, Ippolito, Renato, Cappuccio, Francesco P., Strazzullo, Pasquale
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.08.2012; Elsevier
• Subjects: administration & dosage; adverse effects; Biological and medical sciences; case-control studies; Diet; etiology; Feeding Behavior; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; Gastric cancer; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; longitudinal studies; Medical sciences; Meta-analysis; physiopathology; prospective studies; quantitative analysis; risk; Risk Factors; Salt intake; Sodium; sodium chloride; Sodium Chloride, Dietary; Sodium Chloride, Dietary - administration & dosage; Sodium Chloride, Dietary - adverse effects; Stomach cancer; stomach neoplasms; Stomach Neoplasms - etiology; Stomach Neoplasms - physiopathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; systematic review; Tumors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; RR; Sodium; CI; MeSH; HR; Gastric cancer; Stomach cancer; Salt intake; Meta-analysis; Hazard Ratio; Confidence Interval; Medical Subject Headings; Relative Risk; Consumption; Prospective; Salt; Risk factor; Digestive diseases; Metabolic diseases; Risk; Malignant tumor; Cancer; Gastric disease; Metaanalysis
• ISSN: 0261-5614; 1532-1983; 1532-1983
• DOI: 10.1016/j.clnu.2012.01.003

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. 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. 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. Dietary salt intake was directly associated with risk of gastric cancer in prospective population studies, with progressively increasing risk across consumption levels.