ATTRIBUTABLE RISKS FOR STOMACH-CANCER IN NORTHERN ITALY

The proportions of gastric cancer cases attributable (or attributable risks, AR) to consumption of traditional foods (i.e., pasta, rice and maize), low intake of beta-carotene and vitamin C, short duration of u se of an electric refrigerator, low educational level, and family hist ory of gastric cancer were computed using data from a case-control stu dy conducted in Northern Italy. Between 1985 and lune 1993 a total of 746 incident, histologically confirmed gastric cancer cases and 2,053 controls admitted to the same network of hospitals for acute, nonneopl astic, non-digestive-tract diseases, unrelated to long-term modificati ons of diet, were interviewed. The ARs were 48% for low intake of beta -carotene, 40% for high consumption of traditional foods, and 16% for low intake of vitamin C. Overall, these 3 dietary factors explained 73 % of the gastric cancer cases in the population. Five percent of all c ases were attributable to less than 30 years' use of an electric refri gerator, 15% to low educational level, and 5% to family history of gas tric cancer. In individuals over age 60, a greater proportion of cases was attributable to traditional foods, low education and late adoptio n of electric refrigeration (58% vs. 32% aged under 60), suggesting th at correlates of lower social class, influenced lifestyle and dietary habits more markedly in earlier than in more recent generations. Accor ding to our estimates, over 3 quarters of the gastric cancer cases in this area are explainable in terms of the risk factors considered. Inc reased consumption of vitamin C and beta-carotene, and reduced consump tion of traditional foods, would help to avoid over 10,000 out of 14,0 00 stomach-cancer deaths in Italy every year. Consequently, stomach ca ncer, which is still the third leading cause of cancer death in Italy, would represent only about 2% of all cancer deaths. (C) 1995 Wiley-Li ss, Inc.