Despite the gradual decrease of its incidence, stomach cancer is still the
second most common cause of cancer-related death worldwide. It has been
proposed that the risk for gastric cancer may be associated with dietary
factors. The traditional Mediterranean Diet (MD) has been shown to be inversely
related to cancer incidence.
Our goal was to investigate the relation between the intake of several food
groups, as well as the adherence to traditional Mediterranean Diet, and the
incidence of gastric cancer in the Greek component of the European Prospective
Investigation into Cancer and nutrition (EPIC) study.
After a median of 10.7 years, 26,426 participants (10,972 men, 15,454 women)
were actively followed-up, contributing 258,977 person-years. Stomach cancer
was diagnosed in 61 participants (42 men, 19 women). Dietary intakes were
ascertained at enrollment through an extensive, validated,
interviewer-administered food frequency questionnaire. Data were analyzed
through Cox regression, controlling for potential confounders.
Inverse associations of gastric cancer incidence with olive oil intake (hazard
ratio per gr/day; 0.985, 95 % CI, 0.97 – 0.99), monounsaturated lipids intake
(hazard ratio per gr/day; 0.974, 95 % CI, 0.95– 0.99), as well as adherence to
Greek religious diet (hazard ratio; 0.535, 95 % CI, 0.34 – 0.85) were observed.
On the other hand, consumption of salty biscuits and crackers was related to
increased incidence of stomach neoplasia (hazard ratio per gr/day; 1.073, 95 %
CI, 1.03 – 1.12). No statistically significant association was found between
adherence to MD and gastric cancer occurrence, probably due to lack of power.
In a general population – based Greek cohort we have found evidence that
consumption of certain foods/nutrients and adherence to the Greek religious
diet are associated with stomach cancer incidence.
Gastric cancer, Mediterranean Diet, Olive oil, Survival analysis, EPIC Study