NUTRITION AND STOMACH-CANCER

Epidemiologic evidence on the relation between nutrition and stomach c ancer is reviewed. Stomach cancer shows a distinct international varia tion and dramatic worldwide decline. These descriptive features sugges t that dietary factors are important in determining the risk of stomac h cancer. The authors assessed relevant data regarding specific dietar y hypotheses in the etiology of stomach cancer. A negative association with fresh vegetables and fruits is highly consistent in numerous cas e-control studies in different populations. Both epidemiologic and exp erimental data suggest that vitamins C and carotenoids lower risk of s tomach cancer. Evidence is sparse and inconsistent as to protective ef fects of vitamin E and selenium. Epidemiologic studies have not lent, and will not provide, supportive evidence for an etiologic role of nit rate intake. High salt intake has been associated with an increased ri sk in many case-control studies and limited cohort studies. Taken toge ther with animal data, it is considered that high salt intake is a ris k factor for stomach cancer. Both epidemiologic and experimental data are inconclusive as to whether high-starch diets confer an increased r isk. Cohort studies using quantitative dietary assessment and biologic measurement of micronutrients are needed for further understanding of etiologic roles of dietary factors in the causation of stomach cancer .