Quit early! Gastric cancer is the fifth most common cancer in the world and the third major cause of cancer death in the world. It is a serious threat to human health.
according to the data of "gastric cancer diagnosis and treatment guidelines (2018 Edition)" issued by the National Health Commission, there are about 1.2 million new gastric cancer cases in the world every year, and China accounts for about 40% of them. Roughly estimated, there are nearly 500000 new gastric cancer patients in China every year, equivalent to nearly 1400 people every day.
recently, a team of researchers from the Cancer Hospital of Peking University conducted a 22.3 year study, involving 3365 residents in Linqu, Shandong, to explore the association between lifestyle factors and the incidence rate and mortality of gastric cancer.
found that the common intervention of Helicobacter pylori eradication therapy, vitamin and garlic supplement was related to the long-term decline in incidence and mortality of gastric cancer. Secondly, the latest two analysis of the study found that smoking is an important killer of gastric cancer, which increased the incidence rate of gastric cancer by 72% and increased the mortality by 101%.
the study was published online in JAMA network open.
diagram 1: research published online in JAMA Network Open, then the incidence rate of gastric cancer is so high, so many people smoking around, how should I protect myself? How to persuade the old smokers around to quit smoking? Don't worry, look down, the following data, in persuading old smokers to quit smoking, you must use it! Long term consumption of garlic can reduce the mortality rate of gastric cancer by 34%. In 1995, researchers started a Shandong intervention trial in Linqu County, Shandong Province to evaluate the effect of Helicobacter pylori eradication treatment (amoxicillin and omeprazole) for 2 weeks and vitamin C / E and garlic supplement for 7.3 years on gastric cancer.
why Linqu County, Shandong Province? Because this is only 1834 square kilometers, and the population is 880 thousand, it is almost the highest incidence rate of gastric cancer in China. (to know that China is a large country with gastric cancer, the number of cases in 2017 accounts for about half of the total number of East Asia.
Figure 2: research flow chart. After 22.3 years of follow-up, the researchers found that Helicobacter pylori eradication therapy (or 0.48; 95% CI 0.32-0.71) and vitamin supplementation (or 0.64; 95% CI 0.46-0.91) could significantly reduce the long-term risk of gastric cancer, while garlic supplementation had no significant effect.
secondly, Helicobacter pylori eradication therapy, vitamin supplement and garlic supplement had significant effect on the prevention of gastric cancer death, which were reduced by 38% (HR 0.62; 95% CI 0.39-0.99), 52% (HR 0.48; 95% CI 0.31-0.75), 34% (HR 0.66; 95% CI 0.31-0.75), respectively 43-1.00), which indicated that the intervention of lifestyle factors may be able to prevent gastric cancer.
3: Helicobacter pylori eradication therapy, vitamin and garlic supplements are related to the incidence rate and mortality rate of gastric cancer. In 2012, the study published by Gastroenterology of West China Hospital in Sichuan University confirmed that organic sulfur compounds in garlic and onion can play a role in Helicobacter pylori in gastrointestinal tract. Bacilli can inhibit the growth of gastric cancer, and reduce the incidence rate of gastric cancer. Increasing 20g garlic and garlic can reduce the incidence rate of gastric cancer by 10%.
however, the study also points out that garlic has certain credibility in preventing gastric cancer, but it is not comprehensive.
garlic can only prevent gastric cancer caused by Helicobacter pylori infection to a certain extent, but not 100%.
in the high-risk population of gastric cancer infected by Helicobacter pylori, do lifestyle factors affect the preventive effect of nutritional supplements? Therefore, the latest secondary analysis of Shandong intervention trial focused on the impact of tobacco, alcohol and diet on gastric cancer, and further tested the interaction between lifestyle factors and two nutritional supplements.
2 smoking can increase the mortality of gastric cancer by 101%, which is equivalent to doubled. The research data show that smoking increases the incidence rate of gastric cancer by 72% (OR 1.72, 95%CI 1.003-2.93), and doubles the mortality rate by 101% (HR 2.01; 95%CI 1.01-3.98).
this association was particularly significant in H. pylori positive individuals, with an increase in morbidity and mortality of 88% (or 1.88; 95% CI 1.01-3.47) and 115% (HR 2.15; 95% CI 1.01-4.61), respectively.
in this regard, the researchers believe that smoking increases the possibility of exposure to carcinogens and N-nitroso compounds, which may partly explain the increased risk of gastric cancer in smokers.
diagram 4: the relationship between lifestyle factors and the incidence rate and mortality of gastric cancer is not a habit of smoking cessation. Eating more garlic is also a useless way to further analyze the effect of lifestyle factors on the preventive effect of dietary supplements. The data show interesting results, and smoking can counteract the preventive benefits of nutritional supplements for gastric cancer.
among the never smokers, the effect of vitamin supplements on gastric cancer mortality was more significant than that of smokers, with a 65% risk reduction (HR 0.35; 95% CI 0.15-0.85).
Table 1: the impact of lifestyle factors on the preventive effect of nutritional supplements is actually as early as 2019. According to the analysis of gastric cancer burden in 195 countries and regions from 1990 to 2017 published by the Lancet journal, the main causes of gastric cancer can be attributed to high sodium diet and smoking. Globally, 38.2% of disability adjusted life years (DALYs) caused by gastric cancer are attributed to high sodium diet and smoking Due to high sodium diet, 17.1% was attributed to smoking, and the number of males was higher than that of females.
of course, smoking not only increases the risk of laryngeal cancer, liver cancer, bladder cancer, lung cancer, esophageal cancer, oral cancer and so on.
I have said so much, so I'd better give up smoking as soon as possible ~ 3. I can't smoke, but can I drink? Although the association between alcohol consumption and gastric cancer was not significant in this study, garlic supplementation showed a preventive effect only in people who never drank alcohol, with a 67% reduction in gastric cancer mortality (HR 0.33; 95% CI 0.15-0.75), while the benefits of garlic supplementation were not observed in drinkers, and the Association was more significant in H. pylori positive participants.
researchers believe that this is because the allyl sulfur compounds contained in garlic can play an anti-cancer role by inhibiting the activation of carcinogens, regulating the metabolism of carcinogens, and inhibiting the formation of DNA adducts with carcinogens. Alcohol can directly damage DNA, cause inflammation and affect the health of gastric flora. Alcohol intake may change the cancer prevention benefits of garlic.
Table 2: in the subgroup of Helicobacter pylori infection, the relationship between garlic supplements and the incidence rate and mortality of gastric cancer is related to alcohol carcinogenesis. As early as 2017, the American Society of Clinical Oncology (ASCO) issued a statement that clearly alcohol is an important carcinogenic factor.
in 2018, a global burden of disease study published in Lancet pointed out that there is no safe drinking dose, even a small amount of alcohol consumption will increase the risk of cancer.
although vitamin 4 is good, don't be greedy. In order to provide more accurate guidance and suggestions for lifestyle intervention in gastric cancer prevention, researchers continue to expand the observation indicators to gastric inflammation and precancerous lesions.
the study found that 42.9% of participants had gastric lesions during 1995-2003.
after analyzing the relevant data, it was found that vitamin supplementation could prevent gastric lesions in people with low fresh fruit and vegetable intake (< 81 kg / year, about ＜ 222 g / day), and vitamin supplements seemed to be counterproductive in people with high intake of fresh fruits and vegetables (≥ 81 kg / year), Vitamin supplements increased the risk of gastric lesions (only in people who were not infected with H. pylori).
in a word, quit smoking and drinking, eat more fresh fruits and vegetables and garlic, keep a good attitude and stay away from gastric cancer! Reference source:  December 13, 2018, National Health Commission of the people's Republic of China, "diagnosis and treatment of gastric cancer (2018 Edition)"  Chinese Medical Tribune today's tumor. No rain, no rainbow -- 30 years of gastric cancer prevention and treatment in Linqu County, Shandong Province. July 7, 2014.  effects of Helicobacter pylori treatment and vitamin and gastric supplement on gastric cancer incidence and mortality: follow-up of a randomized intervention trial[J]. bmj, 2019, 366: l5016.Consumption of Large Amounts of Allium Vegetables Reduces Risk for Gastric Cancer in a Meta-analysis，Gastroenterology，July 2011Volume 141, Issue 1, Pages 80–89Guo Y, Li Z, Zhang J, et al. (2020). Association Between Lifestyle Factors, Vitamin and Garlic Supplementation, and Gastric Cancer Outcomes: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open, DOI: 10.1001/jamanetworkopen.2020.6628Alcohol and Cancer:A Statement Of the American Society of clinical oncology. J Clin Oncol. 2017nov 7: jco2017761155.  medical respiratory channel. 30 pictures to understand the truth of smoking! 2018-09-04.