TY - JOUR T1 - Peptic ulcer as mediator of the association between risk of gastric cancer and socioeconomic status, tobacco smoking, alcohol drinking and salt intake JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health SP - 861 LP - 866 DO - 10.1136/jech-2022-219074 VL - 76 IS - 10 AU - Giulia Collatuzzo AU - Gianfranco Alicandro AU - Paola Bertuccio AU - Claudio Pelucchi AU - Rossella Bonzi AU - Domenico Palli AU - Monica Ferraroni AU - Weimin Ye AU - Amelie Plymoth AU - David Zaridze AU - Dmitry Maximovich AU - Nuria Aragones AU - Gemma Castaño-Vinyals AU - Jesus Vioque AU - Manoli Garcia de la Hera AU - Zuo-Feng Zhang AU - Jinfu Hu AU - Lizbeth Lopez-Carrillo AU - Malaquías López-Cervantes AU - Michela Dalmartello AU - Lina Mu AU - Mary H Ward AU - Charles Rabkin AU - Guo-Pei Yu AU - M Constanza Camargo AU - Maria Paula Curado AU - Nuno Lunet AU - Eva Negri AU - Carlo La Vecchia AU - Paolo Boffetta Y1 - 2022/10/01 UR - http://jech.bmj.com/content/76/10/861.abstract N2 - Background Peptic ulcer disease (PUD) and gastric cancer (GC) are more prevalent in individuals with low socioeconomic status (SES) and share several risk factors. The aim of this study was to investigate the mediating role of PUD in the association between established risk factors and GC.Methods We conducted a pooled analysis of 12 studies from the Stomach Cancer Pooling Project Consortium, including a total of 4877 GC cases and 11 808 controls. We explored the mediating role of PUD in the association between SES, tobacco smoking, heavy alcohol drinking and salt intake, and GC. Also, we assessed the ORs and 95% CIs of the risk factors and both PUD and GC.Results PUD mediated 36% of the smoking effect mainly among men. Other risk factors were only slightly mediated by PUD (SES, 5.3%; heavy alcohol drinking, 3.3%; and salt intake, 2.5%). No significant difference was found when excluding PUD diagnosed within 2 years from GC.Conclusions Our study provides innovative information on the mechanism of stomach mucosal damage leading to PUD and GC, with respect to the effect of tobacco smoking in particular.Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author upon reasonable request and approval by members of StoP Project Consortium. ER -