JAMA Netw Open: 22 years of Chinese group follow-up reveals that smoking doubles the risk of death from stomach cancer, and long-term eating of garlic can be a preventive effect

Gastric canceris a malignant tumor originating in the epithelial of the gastric mucosa, ranking third in the world in cancer mortalityBecause early symptoms are not obvious and are often found at an advanced stage, they are also known as the "silent killer"Every year, about 1.2 million people worldwide suffer from the disease and 170,000 die as a resultAs a major country with a high incidence of stomach cancer, China has nearly half a million new cases each year, accounting for more than 40% of new cases of stomach cancer worldwideSince 1995, a team of researchers at Peking University Cancer Hospital has been exploring the link between lifestyle and stomach cancer morbidity and mortality, and looking for effective ways to stop this "killer." On June 26, local time, the team published their latest research inJAMANetwork OpenThey found that smoking was an important factor in increasing the risk of stomach cancer and mortality compared to alcohol consumption, and that non-smokers couldpreventby eating garlicdoi: 10.1001/jamanetworkopen.2020.6628this is a covert, randomized, placebo-controlled trial in Linyi County, Shandong Province, which is a high-risk area for stomach cancerBetween July 1995 and December 2017, a total of 3,365 villagers between the ages of 35 and 64 participated in the trial, with an average age of 47.1 years and a female share of 48.7 per centDuring the follow-up period, 151 people had stomach cancer and 94 died of the diseasethe main results of the study were to assess the effects of lifestyle, vitamin supplementation and garlic supplements on the incidence and mortality of stomach cancer, and the secondary result was to explore the progress of gastric lesions among participants between 1995 and 2003 analysis showed that smoking was the number one "killer" in the stomach, increasing the risk of stomach cancer by 72 per cent and death by a staggering 101 per cent This association was more pronounced in participants who were positive about Helicobacter pylori, with an 88 per cent increase in the incidence of stomach cancer and an 115 per cent increase in mortality The correlation between alcohol consumption and dietary factors and stomach cancer was not obvious The association between lifestyle factors and the incidence and mortality of stomach cancer Further analysis of lifestyle and nutritional supplements showed that smoking and diet did not significantly affect the prevention and improvement of vitamin supplements, but non-drinkers reduced the risk of death from stomach cancer by 67% by adding garlic, and the association was more pronounced in participants with positive Helicobacter pylori The researchers believe this is because garlic contains propylene-based sulfur compounds that can fight cancer by inhibiting the activation of carcinogens, regulating the metabolism of carcinogens, and inhibiting the formation of DNA compounds with carcinogens between 1995 and 2003, 42.9 per cent of the participants developed stomach lesions After analyzing the data, the researchers found that vitamin supplementation was a preventive effect in people with low intake of fresh fruits and vegetables (81 kg/y), reducing the risk of stomach lesions by 20%, while vitamin supplementation increased the risk of stomach lesions in people with high eras and vegetables intake in short, this study provides new insights into lifestyle interventions for gastric cancer prevention, suggesting that large-scale gastric cancer prevention strategies may need to be adapted to target lifestyle groups to maximize potential beneficial effects