| Background & ObjectiveThe gastric cancer is one of the most common malignant tumors which impair human's health.The incidence of gastric cancer has decreased in many Western countries during the last decades.However,the incidence and the mortality of gastric cancer are increasing in China,which has made gastric cancer become one focus of tumor research. Although some progress has been made in the causation of gastric cancer,no definite conclusion has been drawed till now.There are different viwepoints on the risk factor of gastric cancer.Most of studies consider that the cause of gastric cancer is complicate, which is induced by multi-risk factors.In addition,the cancer has obvious regional characteristics,and most scholars classified its risk factors into following aspects:The diet,life style and custom,heredity,history of disease,the pylorus helicobacter pylori infection,stress disorder,source of drinking water,physical constitution and so on, among which diet is the most important one.Surveillance system on the mortality of gastric cancer had been established in Cixi city since 1989.According to the information of gastric cancer among inhabitants in Cixi city from 1995 to 2006,the average mortality of gastric cancer was 34.08/100,000, occupied 20.74%of the mortality with malignant tumorTo explore the causation of the high incidence of gastric cancer and provice evidence for the disease control and prevention,a case-control study was carried out. Materials & MethodsThe 1:1 matched case-control study was applied.Patients suffered with gastric cancer were diagnosed by city hospital before April 1,2006.Meanwhile,controls were healthy people without related diseases,additionaly,the age(±3years),gender,and the resident area(same country)were similar between patients and controls.Both patients and controls have lived in Cixi more than ten years.Unified questionnaire for resident health was made and was investigated in advance.The objects were interviewed by investigator who was trained and passed the examination,then relative information of patients and controls were collected according to the questionnaire and handbook.The primary contents of study:diet habit,lifestyle,habits(tea drinking alcohol consuming and smoking),heredity,history of disease,psychology,female physiology and bearing as well as physical constitution.All the data obtained through investigation was input into computer by two persons,and was analyzed by statistic software(spss 13.0 software for windows)after checkout.The value of odds ratio(OR),95%confidence interval(95%CI),and P value were calculated by single-variable logistic regression.The OR value of the factors with significant statistic correlation were adjusted using multi-variable logistic regression model.ResultsThe results of single-variable analysis indicated that the risk of gastric cancer decreased remarkably when people eat more food such as fish and prawns,for example,fresh hairtail(OR=0.46,95%CI:0.25-0.82),fresh squill(OR=0.56,95%CI:0.34-0.96),fresh white herring(OR=0.47,95%CI:0.24-0.99),jerryfish(OR=0.42,95%CI:0.26-0.71), kelp and laver(OR=0.52,95%CI:0.31-0.84).The OR value of jerryfish was still statistic significant(OR=0.52,95%CI:0.32-0.80)when other factors were adjusted. The white meat was negatively correlated(OR=0.39,95%CI:0.24-0.66)with the occurrence of gastric cancer,and its OR value was still statistic significant(OR=0.52,95 %CI:0.32-0.80)when other factors were adjusted.Smoking and alcohol consuming are risk factors of gastric cancer,contrarily;tea drinking is the protective factor against gastric cancer.The results of this study suggested that the risk of gastric cancer increased remarkably(OR=2.16,95%CI: 1.10-4.23)when smoking more than 30 years.It was found that drinking yellow wine was one of the risk factors(OR=1.00,95%CI:1.00-1.00,P=0.02)of gastric cancer. Green tea drinking was the protective factor(OR=0.60,95%CI:0.37-0.85,P=0.04) against gastric cancer.The difference of peptic ulcer between patients and controls was significant,the OR value was 11.0,(P＜0.01),and it was still a risk factor(OR=18.04,95%CI:3.94-82.56) when other factors were adjusted.Six factors among psychological factors,including character of type A,poor self-adjusting ability,maladjustment,being prone to anger,often worrying about family problems,bad mood,depression were related to the occurrence of gastric cancer,,and the OR value were2.18,3.69,2.05,1.80,10.41and 3.00(P＜0.05),respectively.The character of type A and poor self-adjusting ability were still correlated with gastric cancer when other factors were adjusted,and their OR value were 2.26(95%CI: 1.45-3.55)and 2.63(95%CI:1.00-6.91),respectively.The results of multi-variable analysis suggested that the use of smoke exhauster was a protective factor against gastric cancer(OR=0.60,95%CI:0.38-0.95).ConclusionThe study indicates that the occurrence of gastric cancer in Cixi city may be related to the synthetic action by history of peptic ulcer,diet and drinking,psychology and so on. The history of peptic ulcer,smoking,drinking yellow wine,character of type A poor self- adjusting ability,maladjustment,being prone to anger,often worrying about family problems,bad mood and depression may be the risk factors of gastric cancer,and green tea drinking,eating more fish and pawns as well as white meat and the use of smoke exhauster may be the protective factors against gastric cancer.
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