Determinants of gastric cancer incidence among residents of Henan province: a case-control study

ObjectiveTo understand the influencing factors of gastric cancer incidence among residents in Henan province, providing a reference for the formulation of local gastric cancer prevention and control strategies. MethodsThrough the Henan Provincial Cancer Registration and Reporting System, 198 gastric cancer patients (141 males and 57 females with a median age of 66 years) newly diagnosed between January 2020 and July 2021 in four counties in the Huaihe River basin were selected as the case group. A 1:2 sex and age matching was performed to select 396 healthy residents from the same or adjacent counties as the control group. A face-to-face interview with a standardized questionnaire developed by a group of domestic researchers, physical examination, salt taste threshold test, and detection of Helicobacter pylori infection were conducted among the participants. Conditional logistic regression models were used to analyze the factors influencing gastric cancer morbidity. ResultsCompared to controls, cases had significantly higher proportions of smoking (57.6% vs. 49.7%), exposure to secondhand smoke (69.2% vs. 60.6%), daily water intake < 1 000 ml (52.0% vs. 33.1%), frequent anger (17.2% vs. 4.5%), poor mood or increased stress in the last 10 years (27.8% vs. 9.3%), preference for salty food (47.0% vs. 28.5%), with a salt taste threshold of 4 (34.8% vs. 24.5%), preference for hot food (36.9% vs. 27.5%), preference for hard food (19.2% vs. 8.8%), preference for spicy food (51.5% vs. 40.7%), occasionally or frequently eating leftovers (70.7% vs. 49.7%), eating or handling moldy food (8.1% vs. 2.5%), eating pickled food more than once a week (21.2% vs. 11.9%), being underweight (11.6% vs. 1.8%), and having a history of gastric disease (54.0% vs. 29.0%) (all P < 0.05), whereas cases had significantly lower proportions of drinking alcohol (11.1% vs. 36.1%), drinking tea (16.2% vs. 25.0%), being physically active three or more days a week (15. 2% vs. 23.7%), walking after meals three or more days per week (34.3% vs. 48.5%), using a water filter at home (26.8% vs. 41.9%), eating regular meals (78.8% vs. 89.4%), eating breakfast every day (86.9% vs. 92.7%), and consuming 10 or more grams of raw garlic or garlic sprouts per day (25.3% vs. 33.8%) (all P < 0.05). Multivariate conditional logistic regression analysis revealed the following risk factors for gastric cancer incidence among residents: exposure to secondhand smoke, frequent anger, poor mood or increased stress in the past 10 years, preference for salty food, preference for hard food, occasional or frequent consumption of leftovers, being underweight, having a history of gastric disease, and family history of gastric cancer; the analysis also revealed the following protective factors against gastric cancer incidence: having an education of junior high school or above, having an annual household income of ≥ 5 000 Chinese yuan per capita, using a water filter at home, and being overweight or obese. ConclusionLifestyle, personality and emotional characteristics, dietary habits, history of gastric diseases, and family history of gastric cancer are the main influencing factors of gastric cancer morbidity among residents in Henan province.