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Gastric cancer risk is reduced by predominantly antioxidant factors in the oxidative balance: a hospital-based case-control study
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Jimi Kim, Jeonghee Lee, Il Ju Choi, Young Il Kim, Jeongseon Kim
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Epidemiol Health. 2022;e2022089. Published online October 17, 2022
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DOI: https://doi.org/10.4178/epih.e2022089
[Accepted]
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 Abstract
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Abstract
Objectives
Gastric carcinogenesis is linked to oxidative stress from both exogenous and endogenous exposures. This study aims to determine the association between the risk of gastric cancer and the oxidative balance score (OBS) comprising antioxidant and pro-oxidant factors, including diet and lifestyle.
Methods For this hospital-based case-control study, 808 controls and 404 patients with gastric cancer who had clinical records indicating Helicobacter pylori infection and the histological subtype were recruited. The OBS was based on diet and lifestyle factors obtained from a 106-item semiquantitative food frequency questionnaire and a constructed questionnaire. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
Results Higher OBS were associated with a reduced gastric cancer risk (OR, 95% CI T3 vs. T1 = 0.49, 0.33-0.71, P for trend < 0.001). In the subgroup analysis, antioxidant factors showed inverse associations with the gastric cancer risk (OR, 95% CI T3 vs. T1 = 0.53, 0.35-0.79, P for trend = 0.003). A stronger association with antioxidant factors was observed in patients with intestinal gastric cancer (OR, 95% CI T3 vs. T1 = 0.34, 0.19-0.62, P for trend < 0.001) and those with H. pylori infection (OR, 95% CI T3 vs. T1 = 0.57, 0.37-0.88, P for trend = 0.014).
Conclusions Antioxidant factors from diet and lifestyle predominantly reduce the risk of gastric cancer compared to pro-oxidant factors. A combined effect on oxidative stress, which involves an altered balance between antioxidants and pro-oxidants, is important to modulate the risk of gastric cancer.
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