A Review on the Ephidemiology of Stomach Cancer

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This paper reviews descriptive features of stomach cancer and current evidence for postulated etiological factors. Stomach cancer displays distinct patterns in its distribution: wide international variation, remarkable worldwide decline, and large differences in risk among populations of the same origin but living in different countries. All these descriptive features indicate that dietary factors play an important role in the causation of stomach cancer. Among reported associations with various foods, an inverse association with fresh vegetables and fruits and a positive one with salted foods are the most consistent. Those associations are in part supported by experimental studies. Much evidence from laboratory studies indicates that dietary vitamin C and beta-carotene are protective. A positive relation between Helicobacter pylori infection and stomach cancer risk has been consistently observed, but ubiquitousness of the infection weakens its causal implication. Further case-control studies on diet are unlikely to reveal new findings ; exception may be possible protective effects of green tea and garlic. On the basis of current available evidence, it appears desirable to consume less high-salt foods and to eat more fresh fruits and vegetables in order to prevent the occurrence of stomach cancer. J Epidemiol, 1994; 4 : 1-11.