PT  - JOURNAL ARTICLE
AU  - Collatuzzo, Giulia
AU  - Alicandro, Gianfranco
AU  - Bertuccio, Paola
AU  - Pelucchi, Claudio
AU  - Bonzi, Rossella
AU  - Palli, Domenico
AU  - Ferraroni, Monica
AU  - Ye, Weimin
AU  - Plymoth, Amelie
AU  - Zaridze, David
AU  - Maximovich, Dmitry
AU  - Aragones, Nuria
AU  - Castaño-Vinyals, Gemma
AU  - Vioque, Jesus
AU  - Garcia de la Hera, Manoli
AU  - Zhang, Zuo-Feng
AU  - Hu, Jinfu
AU  - Lopez-Carrillo, Lizbeth
AU  - López-Cervantes, Malaquías
AU  - Dalmartello, Michela
AU  - Mu, Lina
AU  - Ward, Mary H
AU  - Rabkin, Charles
AU  - Yu, Guo-Pei
AU  - Camargo, M Constanza
AU  - Curado, Maria Paula
AU  - Lunet, Nuno
AU  - Negri, Eva
AU  - La Vecchia, Carlo
AU  - Boffetta, Paolo
TI  - Peptic ulcer as mediator of the association between risk of gastric cancer and socioeconomic status, tobacco smoking, alcohol drinking and salt intake
AID  - 10.1136/jech-2022-219074
DP  - 2022 Oct 01
TA  - Journal of Epidemiology and Community Health
PG  - 861--866
VI  - 76
IP  - 10
4099  - http://jech.bmj.com/content/76/10/861.short
4100  - http://jech.bmj.com/content/76/10/861.full
SO  - J Epidemiol Community Health2022 Oct 01; 76
AB  - 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.