Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 21, 2009; 15(43): 5472-5480
Published online Nov 21, 2009. doi: 10.3748/wjg.15.5472
Etiologic factors of gastric cardiac adenocarcinoma among men in Taiwan
Mei-Ju Chen, Deng-Chyang Wu, Jia-Ming Lin, Ming-Tsang Wu, Fung-Chang Sung
Mei-Ju Chen, Jia-Ming Lin, Fung-Chang Sung, Institute of Environmental Health, National Taiwan University College of Public Health, 17 Xuzhou Road, Zhongzheng District, Taipei City 100, Taiwan, China
Mei-Ju Chen, Department of Nursing, Chung Hwa University of Medical Technology, 89 Wen-Hwa 1st Street, Jen-Te Hsiang, Tainan Hsien 717, Taiwan, China
Deng-Chyang Wu, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tz-You 1st Road, Kaohsiung City 807, Taiwan, China; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan, China; Research of Excellence for Environmental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan, China
Ming-Tsang Wu, Department of Family Medicine, and Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University Hospital, 100 Tz-You 1st Road, Kaohsiung City 807, Taiwan, China
Fung-Chang Sung, Institute of Environmental Health, China Medical University, College of Public Health, 91 Hsueh-Shih Road, Taichung 404, Taiwan, China
Author contributions: Chen MJ and Sung FC contributed equally to this work; Chen MJ, Lin JM, and Sung FC designed the research; Chen MJ, Wu DC and Wu MT provided data and performed the research; Chen MJ, Lin JM and Sung FC carried out the analysis and interpretation of data; Chen MJ and Sung FC wrote the manuscript.
Supported by China Medical University, Republic of China for Project Grant (CMU-EM01 and CMU94-074)
Correspondence to: Dr. Fung-Chang Sung, Institute of Environmental Health, China Medical University, 91, Hsueh Shih Road, Taichung 404, Taiwan, China. fcsung@mail.cmu.edu.tw
Telephone: +886-4-22035740 Fax: +886-4-22019901
Received: July 30, 2009
Revised: September 10, 2009
Accepted: September 17, 2009
Published online: November 21, 2009
Abstract

AIM: To elucidate etiologic associations between Helicobacter pylori (H pylori), lifestyle, environmental factors and gastric cardiac adenocarcinoma (GCA) among men.

METHODS: A hospital-based case-control study was conducted in Taiwan from 2000 to 2009. All cases were newly confirmed as primary GCA. Five controls were selected matching with age, sex, and admission date to each case. Participants were informed of potential risk factors with a structured questionnaire by trained interviewers during hospitalization and provided a blood sample for the determination of H pylori infection. Odds ratio (OR) and 95% confidence interval (95% CI) were used to evaluate risk, and a multivariate conditional logistic regression model was performed.

RESULTS: All participants recruited for this study were men, consisting of 41 cases and 205 controls. Results of the univariate analysis showed that significant factors associated with the etiology of GCA included H pylori (OR = 2.69, 95% CI = 1.30-5.53), cigarette smoking (OR = 2.28, 95% CI = 1.05-4.96), working or exercising after meals (OR = 3.26, 95% CI = 1.31-8.11), salted food (OR = 2.51, 95%CI = 1.08-6.11), fresh vegetables (OR = 0.28, 95% CI = 0.09-0.80), fruits (OR = 0.19, 95% CI = 0.04-0.89), and rice as principal food (OR = 0.53, 95% CI = 0.30-0.85). Multivariate conditional logistic regression models indicated that a significantly elevated risk of contracting GCA was associated with working or exercising after meals (OR = 3.18, 95% CI = 1.23-9.36) and H pylori infection (OR = 2.93, 95% CI = 1.42-6.01). In contrast, the consumption of fresh vegetables (OR = 0.22, 95% CI = 0.06-0.83), fruits (OR = 0.28, 95% CI = 0.09-0.79) and rice as principal food (OR = 0.48, 95% CI = 0.24-0.93) remained as significant beneficial factor associated with GCA.

CONCLUSION: Working or exercising after meals and H pylori infection increase the risk of GCA, but higher intakes of rice, fresh vegetables and fruits reduce the risk.

Keywords: Gastric cardiac adenocarcinoma; Helicobacter pylori; Diet; Obesity; Gastroesophageal reflux disease; Cigarette smoking; Family history