Review
Copyright ©2009 The WJG Press and Baishideng.
World J Gastroenterol. May 14, 2009; 15(18): 2204-2213
Published online May 14, 2009. doi: 10.3748/wjg.15.2204
Table 1 Summary of 45 case-control studies that evaluated the association between salt consumption and stomach cancer risk
Author and yearNo. of casesNo. of controlsFactors evaluatedExposure levels and OR (95% CI)1
SALT AND SODIUM INTAKE
Modan et al, 1974: Israel[23]166429SaltNo association
Risch et al, 1985: Canada[24]246246SaltNo association
You et al, 1988: China[25]5641131Salt (per capita household)≤ 13 kg/yr, ≤ 19 kg/yr, ≤ 20 kg/yr, > 20 kg/yr
1.0, 1.2, 1.1, 1.1 (0.8-1.4); NS
Negri et al, 1990: Italy[26]5261223SaltLow, intermediate, salty
1.0, 1.3, 1.2 (0.8-1.7); NS
Wu-Willians et al, 1990: USA[27]137 male137Add saltRarely, often, always
1.0, 1.4, 1.2 (Na); NS
Nazario et al, 1993: Puerto Rico[28]136151Salt≤ 6.979 g/wk; 6.98-18.66 g/wk; 18.67-43.26 g/wk; ≥ 43.27g/wk
1.0, 2.9, 4.5, 5.0 (2.1-12.0); P < 0.05
Ramón et al, 1993: Spain[29]117234SaltQuartiles 1 through 4
1.0, 1.2, 1.8, 2.1 (1.2-7.1); P for trend < 0.01
Lee et al, 1995: Korea[30]213213SaltTertile 3 vs 1
3.7 (1.1-12.5); P < 0.05
La Vecchia c et al, 1997: Italy[31]7462053SaltLow, intermediate or high
1.0, 1.5 (1.0-2.2); P < 0.05
Ye et al, 1998: China[32]272544Salt0.25 kg/m; > 0.25 kg/m
1.0, 1.3 (1.0-1.6); NS
López-Carrillo et al, 1999: Mexico[33]220752SaltNever, sometimes (adding salt after tasting the food)
Positive association; P < 0.05
Liu et al, 2001: China[34]189189Heavy saltLow to high half
1.0, 2.0 (1.3-3.2); P < 0.05
Machida-Montani et al, 2004: Japan[35]122235SaltTertiles 1 through 3
1.0, 1.3, 1.5 (0.6-3.7); N
Qiu et al, 2004: China[36]103133SaltPositive association; P < 0.05
La Vecchia et al, 1987: Italy[37]206474Table saltTertile 3 vs 1
1.5 (Na); NS
Tuyns et al, 1988: Belgium[38]2932851Table saltNever, sometimes, always
1.0, 1.0, 1.8 (1.2-2.8); P < 0.05
Buiatti et al, 1989: Italy[39]10161159Table saltSeldom, always
1.5 (1.3-1.9); NS
Coggon et al, 1989: England[40]95190Table saltLow to high half
1.0, 6.2 (2.0-18.9); P < 0.05
Boeing et al, 1991: Germany[41]143579Table saltNo association
Boeing et al, 1991: Poland[42]741741Table saltLow to high half
1.0, 1.6 (1.2-2.3); P < 0.05
Graham et al, 1990: USA[43]Sodium intake≤ 73.2 g/mo; 73.2-98.8 g/mo; ≤ 98.9-127.3 g/mo; > 127.3 g/mo
186 male1811.0, 1.8, 2.6, 3.1 (1.7-5.8); P for trend = 0.001
≤ 66.9; 67.0-88.5; > 88.5
107 female1041.0, 1.8, 4.7 (2.3-9.6); P for trend = 0.0001
Harrison et al, 1997: USA[44]132Sodium intakeLow to high half
60 intestinal1.0, 1.3 (0.8-1.9); NS
31 diffuse1.0, 1.4 (0.9-2.1); NS
SALTY FOODS
Salted fish
Haenszel et al, 1972: Japan[45]220440Salted/dried fishNone, use both, 2 times/mo; 3-5 times/mo; 6 times/mo
1.0, 2.0, 1.5, 2.5, 2.6 (Na); P < 0.05
Haenszel et al, 1976: Japan[46]7831566Salted/dried fishNone; < 4 times/mo; 4-9 times/mo; ≥ 10 times/mo
1.0, 1.1, 1.1, 1.2 (Na); NS
Tajima et al, 1985: Japan[47]93186Salted/dried fishLow to high half
1.0, 2.6 (Na); P < 0.01
You et al, 1988: China[25]5641131Sated fish≤ 0.5 kg/yr, ≤ 1 kg/yr, > 1 kg/yr
1.0, 1.0, 1.4 (0.8-1.5); NS
Buiatti et al, 1989: Italy[39]10161159Salted/dried fishTertile 3 vs 1
1.4 (Na); P for trend = 0.001
Kato et al, 1990: Japan[48]< 2-3 times/wk; ≥ 2-3 times/wk
289 male1247Salted/dried fish1.0, 1.2 (0.9-1.7); NS
Salted fish gut, cod roe1.0, 1.5 (1.1-2.1); P < 0.05
138 female1767Salted/dried fish1.0, 0.7 (0.5-1.0); NS
Salted fish gut, cod roe1.0, 0.5 (0.3-1.0); NS
González et al, 1991: Spain[49]354354Salted fishLow to high half
1.0, 1.5 (0.9-2.6); NS
Palli et al, 1992: Italy[50]1159Salted/dried fishTertile 3 vs 1
68 cardia1.7 (0.9-3.1); NS
855 others1.5 (1.2-1.8); NS
Hansson et al, 1993: Sweden[51]338669Salted fishNone, ≤ 0.9 times/mo; ≤ 3 times/mo; ≤ 7 times/mo; ≤ 11 times/mo
1.0, 1.0, 0.9, 0.9, 1.3 (0.8-2.1); NS (adolescence)
None, ≤ 0.9 times/mo; ≤ 3 times/mo; ≤ 7 times/mo
1.0, 1.0, 0.8, 0.8 (0.5-1.3); NS (20 yr prior to interview)
Kim et al, 2002: Korea[52]136136Salted fishTertiles 1 through 3
1.0, 0.8, 0.8 (0.4-1.6); NS
Cai et al, 2003: China[53]381222Salty fish< times/mo, < 3 times/wk, ≥ 3 times/wk
1.0, 1.0, 5.5 (1.4-19.5); NS
Strumylaite et al, 2006: Lithuania[54]3791137Salted fishAlmost do not use, 1-3 times/mo
1.0, 0.7 (0.5-0.9); P for trend = 0.002
Salted vegetable
You et al, 1988: China[25]5641131Sated vegetables< daily, daily
1.0, 1.1 (0.7-1.8); NS
Ye et al, 1998: China[32]272544Salted vegetables< 2 kg/yr; > 2 kg/yr
1.0, 1.4 (1.1-1.8); P < 0.05
Kim et al, 2002: Korea[52]136136Salted vegetablesTertiles 1 through 3
1.0, 0.9, 1.5 (0.8-2.9); NS
Xibin et al, 2002: China[55]210630Low to high half
Pickled or salted vegetables1.0, 4.0 (1.6-9.8); P < 0.05
Preference for a high salt vegetables1.0, 2.6 (1.6-4.3); P < 0.05
Cai et al, 2003: China[53]381222Pickled vegetables< times/M, < 3 times/w, ≥ 3 times/wk
1.0, 1.3, 1.8 (1.0-3.0); P for trend = 0.038
Strumylaite et al, 2006: Lithuania[54]3791137Pickled vegetables with salt and oilAlmost do not use, 1-3 times/mo, ≥ 1-2 times/wk
Pickled vegetables with salt and vinegar1.0, 0.6, 0.8 (0.6-2.1); NS
Salted mushroomsAlmost do not use, 1-3 times/mo, ≥ 1-2 times/wk
1.0,0.7, 0.8 (0.6-1.0); NS
1-3 times/mo, ≥ 1-2 times/wk
1.0, 1.6 (1.1-2.4); NS
Salted snacks
Boeing et al, 1991: Germany[41]143579Pretzels, salty snacksTertiles 1 through 3
1.0, 0.7, 1.5 (1.0-2.2); NS
Ward et al, 1999: Mexico[56]220752Salty snacksNever, ≤ 2, > 2 times/mo
1.0, 1.3, 1.8 (1.2-2.8); P for trend = 0.008
Chen et al, 2002: Nebraska[57]124449Salty snacksQuartiles 1 through 4
1.0, 1.4, 1.2, 0.7 (0.3-1.6);NS
Salted foods in general
Hu et al, 1988: China[58]241241Salted and fermented soya paste< 2 kg/yr; > 2 kg/yr
1.0, 1.5 (1.0-2.2); NS
Kono et al, 1988: Japan[59]1392852Salty foodsNone or 1-3 times/mo; 1-3 times/mo; once/do more
1.0, 0.8, 1.4 (Na): NS
Demirer et al, 1990: Turkey[60]100100Salted foodsLess than once or twice/wk; once or twice/wk vs
1.0, 3.8 (2.1-6.9); P < 0.001
Hoshiyama et al,1992: Japan[61]294294 (general population)Salty foodsNo, moderate, yes
202 (hospital control)1.0, 1.7, 2.3 (1.5-3.4); P < 0.01
1.0, 1.3, 1.1 (0.7-1.9); NS
Ramón et al, 1993: Spain[29]117234Pickled foodsQuartiles 1 through 4
1.0, 1.2, 2.1, 3.7 (Na); P for trend < 0.01
Ji et al, 1998: China[62]11241451Salted foodsOccasionally, sometimes, frequently
1.0, 1.4, 1.7 (1.3-2.4); P for trend = 0.001
Lee et al, 1995: Korea[30]213213Salted side dishesTertile 3 vs 1
4.5 (2.5-8.0); P < 0.05
Ye et al, 1998: China[32]272544Salted fermented sea foods< 1.5 kg/yr; > 1.5 kg/yr
1.0, 1.6 (1.2-2.0); P < 0.01
Kim et al, 2002: Korea[52]136136Salty foodsTertiles 1 through 3
1.0, 1.1, 0.9 (0.4-1.8); NS
De Stefani et al, 2004: Uruguay[63]240960Salted meatTertiles 1 through 3 1.0, 1.3, 2.0 (1.4-2.9); P for trend = 0.0003
Campos et al, 2006: Colombia[64]368431Salting meals before tastingNo, yes
1.0, 3.5 (1.6-7.3); P for trend = 0.001
Strumylaite et al, 2006: Lithuania[54]3791137Salted meatAlmost do not use, 1-3 times/mo, ≥ 1-2 times/wk
1.0, 1.5, 3.0 (2.2-4.0); P for trend < 0.001
Table 2 Summary of 11 cohort studies that evaluated the association between salt consumption and stomach cancer risk
Author and yrSize of cohortNo. of casesLength of follow-up (yr)Factors evaluatedExposure levels and RR (95% CI)1
Salt
Nomura et al, 1990: USA[65]7990 male1504Table salt/shoyuNever-seldom, after tasting, always
1.0, 1.4, 1.0 (0.6-1.6); NS
van den Brandt et al, 2003: Netherlands[66]120 8522826.3Dietary saltQuintiles 1 through 5
1.0, 1.5, 1.0, 1.5, 1.2 (0.8-1.8); NS
Table saltNever, seldom, sometimes, often/very often
1.0, 1.1, 0.7, 0.9 (0.6-1.4); NS
Tsugane et al, 2004: Japan[67]12SaltQuintiles 1 through 5
18 684358Male: 1.0, 1.7, 2.0, 2.3, 2.2 (1.5-3.4); P for trend < 0.001
20 381128Female:1.0, 0.9, 1.0, 0.6, 1.3 (0.8-2.3); NS
Shikata et al, 2006: Japan[68]24769314Dietary salt< 10.0, 10.0-12.9, 13.0-15.9, ≤ 16.0 1.0, 2.1, 1.9, 2.7 (1.4-5.2); P for trend = 0.01
Sjödahl et al, 2008: Sweden[69]73 13331318Dietary saltLow to high half
1.0, 1.0 (0.7-1.4); NS
Salty foods
Kneller et al, 1991: USA[70]17 633 male7520Salted fishNever, < 1, ≥ 1 1.0, 1.0, 1.9 (1.0-3.6); NS
Galanis et al, 1998: USA[71]11 90710814.8 (average)Dried or salted fishNone, 1 or more times/wk
High-salt foods1.0, 1.0 (0.6-1.7); NS
None, 1-3 times/wk, 4 or more times/wk
1.0, 1.0, 1.1, (0.7-1.8); NS
Ngoan et al, 2002: Japan[72]13 00011610Salted foodLow, median, high
1.0, 1.0, 1.4 (0.6-3.2); NS
Kim et al, 2004: Japan[73]40010Salted foodQuartiles 1 through 4
20 300(traditional type)Male:1.0, 2.0, 2.5, 2.9 (1.8-4.7); P for trend < 0.0001
21 812Female: 1.0, 1.7, 1.3, 2.4 (1.3-4.4); P for trend = 0.007
Tokui et al, 2005: Japan[74]110 79212Preference for salty foodNo, a little, somewhat, much, very much
574Male: 1.0, 0.9, 1.1, 1.1, 1.4 (0.7-2.8); NS
285Female: 1.0, 1.6, 1.8, 1.5, 1.9 (0.6-5.8); NS
Dried or salty fishNone, 1-2/mo, 1-2/wk, 3-4/wk, 1+/d
574Male: 1.0, 0.9, 0.9, 0.9, 1.1 (0.7-1.8); NS
285Female:1.0, 0.6, 0.7, 0.7, 0.9 (0.5-1.6); NS
Kurosawa et al, 2006: Japan[75]80357611Salted foodLow, intermediate, high
1.0, 4.0, 5.4 (1.8-16.3); P for trend < 0.01