22-year data on Chinese population: How much influence does tobacco and alcohol have on the risk of gastric cancer? I'm afraid it will offset other anti-cancer benefits...

▎ in China, gastric cancer is the second highest incidence of cancer.as early as 1995, the team of Cancer Hospital of Peking University led a large-scale intervention experiment in Linqu County, Shandong Province. The 22 year follow-up ofpublished in the British Medical Journal (BMJ) showed that Helicobacter pylori therapy and the intervention of vitamin and garlic supplements were associated with a long-term decline in the incidence rate and mortality of gastric cancer.then, in these high-risk groups, will lifestyle factors affect the preventive effect of nutritional supplements? This is exactly the question to be answered in the latest secondary analysis of Shandong intervention trial. The research results published in JAMA network open, a sub Journal of the Journal of the American Medical Association, bring new insights, especially the influence of tobacco and alcohol.screenshot: the yama network open Shandong intervention trial enrolled 3365 residents in Linqu County, a high incidence of gastric cancer, who received two weeks of Helicobacter pylori treatment (amoxicillin and omeprazole) and vitamin supplements (C, e and selenium) and garlic supplements (extracts and oils) or corresponding placebo controls for 7.3 years.overall, 151 new gastric cancer cases and 94 gastric cancer deaths occurred during the 22.3-year follow-up period.previous studies have shown that Helicobacter pylori treatment and vitamin supplements are associated with a 52% and 36% decrease in the risk of gastric cancer, respectively. Garlic supplements also show a trend of protective effect.Helicobacter pylori treatment, vitamin supplements and garlic supplements were associated with a 38%, 52%, and 34% reduction in the risk of gastric cancer death, respectively.Image Source: 123rf in this analysis, researchers focused on the influence of smoking, drinking and eating characteristics on lifestyle factors.data showed that the incidence rate of gastric cancer increased by 72% in smokers, and the risk of death was doubled and 101%.this association was particularly significant in Helicobacter pylori positive people, with an increased risk of 88% and 115% for morbidity and death, respectively.in contrast, although alcohol consumption was also associated with increased risk, it was not statistically significant, and the researchers did not observe the significant impact of grain, meat, vegetables and fruits intake.further analysis of the impact of lifestyle on the preventive effect of nutritional supplements shows interesting results.in people who have never smoked, vitamin supplements have a more significant effect on preventing gastric cancer death, with a 65% reduction in risk.similarly, although alcohol consumption alone was not a significant risk factor, garlic supplements showed a protective effect only in people who never drank alcohol, reducing the risk of gastric cancer death by 67%, while the benefits of garlic supplements were not observed in drinking people, and this cross effect was more pronounced in H. pylori positive people.Image Source: 123rf researchers continue to expand the observation indicators to gastric inflammation and precancerous lesions, and 42.9% of the subjects developed gastric lesions from 1995 to 2003, among which, the intake of fresh fruits and vegetables was insufficient (< 81 kg / year, about < 222) Vitamin supplements also help to slow down the disease and reduce the risk by 20% in the population with adequate intake of vegetables and fruits, but the effect is only shown in those who are not infected with Helicobacter pylori.the author's team pointed out that this analysis was consistent with the results of large-scale prospective studies in Western population and case-control study conducted in Linqu County, supporting that smoking is a risk factor for gastric cancer; although the association between alcohol consumption and gastric cancer is relatively not obvious, the study shows the potential impact of alcohol intake on gastric health, and other studies also show that alcohol can directly damage DNA It can cause inflammation and affect the health of gastric flora. previous community intervention trials in Linqu have shown that smoking and drinking are related to the failure of eradication of Helicobacter pylori. and this study further suggests that alcohol and tobacco may also partly offset the preventive benefits of nutritional supplements for gastric cancer. based on these findings, the research team proposed that in high-risk groups, gastric cancer prevention strategies should be combined with lifestyle intervention to maximize the potential benefits of preventive measures. Title: 123rf reference: Guo y, Li Z, Zhang J, et al. (2020). Association between lifestyle factors, vitamin and gallic supply, and gastric cancer outcomes: a secondary analysis of a randomized clinical trial. JAMA net open, Doi: 10.1001/jamanetworkopen.2020.6628 note: the purpose of this paper is to introduce the progress of medical and health research, not to recommend treatment options. if you need guidance on treatment plan, please go to a regular hospital.