Macronutrient intake and stomach cancer.

Purpose: This study examines the association between intake of selected macronutrients and the risk of stomach cancer in a Northern American population.

Methods: Mailed questionnaires were completed between 1994 and 1997 in eight Canadian provinces by 1,181 incident, histologically confirmed cases of stomach cancer and 5,039 population controls. Information on nutrient intake was obtained using a food frequency questionnaire. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were derived through unconditional logistic regression to adjust for potential confounders, including an estimate of total energy intake.

Results: Intakes of total fat, saturated fat, and cholesterol were significantly associated with the risk of stomach cancer: The ORs for the highest versus the lowest quartile were 1.58 (95% CI 1.13-2.20), 1.86 (95% CI 1.37-2.52), and 1.75 (95% CI 1.36-2.25), respectively. Total fiber was inversely associated with stomach cancer (p = 0.03). The positive associations with intake of total fat and saturated fat were apparently stronger in women, overweight or obese subjects, and ever smokers. Saturated fat was specifically associated with increased risk of gastric cardia cancer, with an OR of 3.31 (95% CI 1.48-7.43).

Conclusions: A diet high in saturated fat appears to increase the risk of stomach cancer, particularly among obese subjects and for gastric cardia cancer.