Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9383
Revised: August 27, 2013
Accepted: September 4, 2013
Published online: December 28, 2013
Processing time: 227 Days and 13.3 Hours
AIM: To study the association between the incidence of gastric cancer and populational exposure to risk/protective factors through an analysis of international databases.
METHODS: Open-access global databases concerning the incidence of gastric cancer and its risk/protective factors were identified through an extensive search on the Web. As its distribution was neither normal nor symmetric, the cancer incidence of each country was categorized according to ranges of percentile distribution. The association of each risk/protective factor with exposure was measured between the extreme ranges of the incidence of gastric cancer (under the 25th percentile and above the 75th percentile) by the use of the Mann-Whitney test, considering a significance level of 0.05.
RESULTS: A variable amount of data omission was observed among all of the factors under study. A weak or nonexistent correlation between the incidence of gastric cancer and the study variables was shown by a visual analysis of scatterplot dispersion. In contrast, an analysis of categorized incidence revealed that the countries with the highest human development index (HDI) values had the highest rates of obesity in males and the highest consumption of alcohol, tobacco, fruits, vegetables and meat, which were associated with higher incidences of gastric cancer. There was no significant difference for the risk factors of obesity in females and fish consumption.
CONCLUSION: Higher HDI values, coupled with a higher prevalence of male obesity and a higher per capita consumption of alcohol, tobacco, fruits, vegetables and meat, are associated with a higher incidence of gastric cancer based on an analysis of populational global data.
Core tip: An ecological study on gastric cancer based on public databases proved to be feasible and promising, and this method can be used to monitor the behavior of the disease globally. The results of this study indicated a higher level of development, coupled with the highest prevalence of male obesity and a higher per capita consumption of alcohol, tobacco, fruits, vegetables and meat, among the countries with the highest incidences of gastric cancer. In contrast, a high consumption of vegetables was associated with a lower disease incidence in other countries.