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Original Article
Dietary mercury intake, the IL23R rs10889677 polymorphism, and the risk of gastric cancer in a Korean population: a hospital-based case-control study
Ji Hyun Kim, Madhawa Gunathilake, Jeonghee Lee, Il Ju Choi, Young-Il Kim, Jeongseon Kim
Epidemiol Health. 2024;46:e2024051.   Published online May 21, 2024
DOI: https://doi.org/10.4178/epih.e2024051
  • 1,892 View
  • 58 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Mercury can stimulate immune responses through T helper 17 (Th17). The gene <i>IL23R</i> is a key factor in Th17 function, which may also contribute to digestive tract diseases. The aim of this study was to identify the associations between dietary mercury and gastric cancer (GC) and to investigate whether the <i>IL23R</i> rs10889677 polymorphism modifies those associations.
METHODS
This case-control study included 377 patients with GC and 756 healthy controls. Dietary mercury intake (total mercury and methylmercury) was assessed using a dietary heavy metal database incorporated into the food frequency questionnaire. <i>IL23R</i> genetic polymorphism rs10889677 (A>C) was genotyped. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression models with adjustments for potential confounders.
RESULTS
A higher dietary methylmercury intake was associated with an elevated risk of GC (OR for the highest vs. lowest tertile [T<sub>3</sub> vs. T<sub>1</sub>], 2.02; 95% CI, 1.41 to 2.91; p for trend <0.001). The <i>IL23R</i> rs10889677 reduced the risk of GC in individuals who carried at least 1 minor allele (OR, 0.62; 95% CI, 0.46 to 0.83; p=0.001; AC/CC vs. AA). Individuals with a C allele exhibited a lower susceptibility to GC through methylmercury intake than those with the AA genotype (OR for the T<sub>3</sub> of methylmercury and AA carriers, 2.93; 95% CI, 1.77 to 4.87; and OR for the T<sub>3</sub> of methylmercury and AC/CC genotype, 1.30; 95% CI, 0.76 to 2.21; p-interaction=0.013).
CONCLUSIONS
Our findings suggest that a genetic polymorphism, rs10889677 in <i>IL23R</i>, plays a role in modifying the association between dietary methylmercury intake and the risk of GC.
Summary
Korean summary
본 연구는 식이 수은과 위암 간의 연관성을 탐색하고, microRNA-lethal-7의 예측된 결합 부위 내에 위치한 IL23R rs10889677 다형성이 이러한 연관성에 영향을 미칠 수 있는지 규명하고자 합니다. 식이 메틸수은 섭취량에 비례하여 위암 발생 위험이 증가하는 경향이 확인되었고, IL23R rs10889677 다형성은 식이 메틸수은으로 의한 위암 발생 위험을 조절하는 인자로 작용할 수 있음을 시사합니다.
Key Message
This study aimed to investigate the associations between dietary mercury and gastric cancer (GC) and to determine whether the IL23R rs10889677 polymorphism, located within a predicted binding site for microRNA-lethal-7, may modify these associations. A higher dietary methylmercury intake was associated with an increased risk of GC, while the IL23R rs10889677 polymorphism may modify the detrimental effect of dietary methylmercury on gastric carcinogenesis.
Systematic Review
Risk factors for stomach cancer: a systematic review and meta-analysis
Jalal Poorolajal, Leila Moradi, Younes Mohammadi, Zahra Cheraghi, Fatemeh Gohari-Ensaf
Epidemiol Health. 2020;42:e2020004.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020004
  • 32,917 View
  • 1,102 Download
  • 154 Web of Science
  • 153 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs.
METHODS
PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ<sup>2</sup>, τ<sup>2</sup>, and I<sup>2</sup> statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.
RESULTS
Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: <i>Helicobacter pylori</i> infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies.
CONCLUSIONS
This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.
Summary

Citations

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Health Statistics
Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011
Yeerae Kim, Jinju Park, Byung-Ho Nam, Moran Ki
Epidemiol Health. 2015;37:e2015006.   Published online February 16, 2015
DOI: https://doi.org/10.4178/epih/e2015006
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AbstractAbstract PDF
Abstract
Stomach cancer is the second most common cancer in Eastern Asia, accounting for approximately 50% of all new cases of stomach cancer worldwide. Our objective was to compare the stomach cancer incidence rates of Asian Americans in Los Angeles with those of native Asians to assess the etiology of stomach cancer from 1988 to 2011. To examine these differences, Asian Americans (Korean, Japanese, Chinese, and Filipino Americans living in Los Angeles, California, USA) and native Asians (from Korea, Japan, China, and the Philippines) were selected for this study. Using the Cancer Incidence in Five Continents database, stomach cancer incidence rates were examined. Data from the National Cancer Registry of Korea were used for native Koreans. Between native countries, the incidence rates in Japan, China, the Philippines, and the US declined over time, but the incidence in Korea has remained constant. The incidences among Asian immigrants were lower than those among native Asians. The incidence rates of males were approximately 2 times higher than those among females in Asian countries were. The effect of immigration on stomach cancer incidence suggests that lifestyle factors are a significant determinant of stomach cancer risk. However, the incidence in Korea remains the highest of these countries
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Original Article
Long-term prediction of gastric cancer mortality in Korea.
Jin Gwack, Yunhee Choi, Hai Rim Shin, Yun Chul Hong, Keun Young Yoo
Korean J Epidemiol. 2005;27(1):163-172.
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AbstractAbstract PDF
Abstract
PURPOSE
This study was carried out to predict the mortality rate for gastric cancer up to 2020 in Korea with forecasting model.
METHODS
The trends of the age-adjusted mortality rate was calculated from 1983 to 2003 using the mortality data of the past 20 years in Korea, and projected up to the year of 2020 with log-linear models for each gender. The number of deaths from gastric cancer was calculated from the predicted mortality rate.
RESULTS
Age-adjusted mortality rates for gastric cancer per 100,000 persons were 32.13 in 1983, 23.95 in 1990, and 15.99 in 2003 for women, and 70.37, 58.74, 41.04 for men, respectively. The expected age-adjusted mortality rates for gastric cancer were 16.50 in 2005, 14.27 in 2010, and 10.66 in 2020 for women, and 39.14, 33.83, 25.28 for men, respectively. In contrast to this decreasing trend, it is predicted that mortality rates for those aged 75 or over would increase steadily. The predicted number of deaths from gastric cancer was 6,519 for women and 13,743 for men in 2020.
CONCLUSIONS
This study suggests that gastric cancer mortality rate would decrease continuously except for some aged groups. The declining trends in gastric cancer mortality are regarded as a result of lifestyle changes, improvements in screening methods and treatments. Strategies for aged groups should be developed in order to control increasing mortality rates.
Summary
Meta-Analysis
The Association between Helicobacter pylori Infection and Gastric Adenocarcinoma: a Review of the Literature.
So Young Oh, Aesun Shin, Seung Sik Hwang, Keun Young Yoo
Korean J Epidemiol. 2002;24(2):93-106.
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AbstractAbstract PDF
Abstract
PURPOSE
Stomach cancer is a major cancer in the world as well as in Korea. Helicobacter pylori infection was suggested causing atropic gastritis, but there has been a debate on the association with the gastric adenocarcinoma. We reviewed recent literatures and meta-analyses on the association between Helicobacter pylori infection and the development of gastric adenocarcinoma. PESULTS: The animal experiments suggested that Helicobacter pylori is a causative agent of gastric adenocarcinoma. Meta-analyses on the relationship between Helicobacter pylori infection and gastric adenocarcinoma showed increased risk in infected person, but the strength of association was varied with study design, characteristics of study participants and the nature of tumors.
CONCLUSIONS
Recent study results suggested that Helicobacter pylori is a necessary causative agent for development of gastric adenocarcinoma. Assessment of the association between Helicobacter pylori infection and other factors related with gastric cancer risks and the effects of the eradication therapy of Helicobacter pylori infection on the prevention of gastvic cancer need further evaluation.
Summary
Epidemiol Health : Epidemiology and Health
© Korean Society of Epidemiology.
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