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Dietary intakes of citrus fruit and risk of gastric cancer incidence: an adaptive meta-analysis of cohort studies

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:: In the context of supplementary antioxidants having no anticancer effect, it is important to update the meta-analysis to evaluate whether there is an association between intake of citrus fruit and gastric cancer risk.

Methods:: The list of articles to be searched was established using citation discovery tools provided by PubMed and Scopus. The effect size of each article to be used in meta-analysis was calculated using the interval-collapse method. Summary effect size (sES) and 95% confidence intervals (CI) were obtained by conducting this meta-analysis. Random effect dose–response meta-regression (DRMR) was performed to investigate the dose–response relationship.

Results:: A total of five cohort studies were selected. The result was 13% reduction of gastric cancer according to the intake of citrus fruit (sES, 0.87; 95% CI, 0.76 to 0.99; I-squared=69.6%). In subgroup analysis, it was found that the intake of citrus fruit inhibited cardia gastric cancer (CGC) (sES, 0.67; 95% CI, 0.55 to 0.81; I-squared=46.1%) and as a result of DRMR, 100 g of citrus fruit intake per day inhibits CGC by 40% (relative risk, 0.60; 95% CI, 0.44 to 0.83).

Conclusions:: It is suggested that the intake of citrus fruit inhibits the development of CGC. This conclusion can be used as a primary prevention measure in the future when the incidence of CGC may be on the rise.

No MeSH data available.


Flow chart of article selection.
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f1-epih-38-e2016034: Flow chart of article selection.

Mentions: Figure 1 shows a flow chart illustrating a series of steps involved in the final selection of articles to be used in the analysis including the searching and evaluating processes. After applying the CDT on the two databases (PubMed and Scopus) based on the eight articles selected in the meta-analysis in Fang et al. [11], we obtained 12,164 records. After combining these records with 32 other records identified through manual searching, we eliminated 8,025 duplicated records. Among the 4,171 remaining records, 3,712 were eliminated based on abstract contents. Copies of the remaining 459 abstracts were obtained and their contents screened, leading to elimination of 454 articles. Five cohort studies were finally selected for the meta-analysis [16-19,32]. A total of 4,166 articles were excluded according to the exclusion criteria: (1) 310 laboratory studies, (2) 972 expert/SRs, (3) 2,430 descriptive studies, (4) 398 analytical studies that do not provide information necessary for the meta-analysis, (5) 52 case-control studies, (6) 2 gastric cancer mortality-based cohort studies [14,15], and (7) 2 cohort studies that were duplicated as a result of extending the follow-up period [12,13].


Dietary intakes of citrus fruit and risk of gastric cancer incidence: an adaptive meta-analysis of cohort studies
Flow chart of article selection.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037356&req=5

f1-epih-38-e2016034: Flow chart of article selection.
Mentions: Figure 1 shows a flow chart illustrating a series of steps involved in the final selection of articles to be used in the analysis including the searching and evaluating processes. After applying the CDT on the two databases (PubMed and Scopus) based on the eight articles selected in the meta-analysis in Fang et al. [11], we obtained 12,164 records. After combining these records with 32 other records identified through manual searching, we eliminated 8,025 duplicated records. Among the 4,171 remaining records, 3,712 were eliminated based on abstract contents. Copies of the remaining 459 abstracts were obtained and their contents screened, leading to elimination of 454 articles. Five cohort studies were finally selected for the meta-analysis [16-19,32]. A total of 4,166 articles were excluded according to the exclusion criteria: (1) 310 laboratory studies, (2) 972 expert/SRs, (3) 2,430 descriptive studies, (4) 398 analytical studies that do not provide information necessary for the meta-analysis, (5) 52 case-control studies, (6) 2 gastric cancer mortality-based cohort studies [14,15], and (7) 2 cohort studies that were duplicated as a result of extending the follow-up period [12,13].

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:: In the context of supplementary antioxidants having no anticancer effect, it is important to update the meta-analysis to evaluate whether there is an association between intake of citrus fruit and gastric cancer risk.

Methods:: The list of articles to be searched was established using citation discovery tools provided by PubMed and Scopus. The effect size of each article to be used in meta-analysis was calculated using the interval-collapse method. Summary effect size (sES) and 95% confidence intervals (CI) were obtained by conducting this meta-analysis. Random effect dose–response meta-regression (DRMR) was performed to investigate the dose–response relationship.

Results:: A total of five cohort studies were selected. The result was 13% reduction of gastric cancer according to the intake of citrus fruit (sES, 0.87; 95% CI, 0.76 to 0.99; I-squared=69.6%). In subgroup analysis, it was found that the intake of citrus fruit inhibited cardia gastric cancer (CGC) (sES, 0.67; 95% CI, 0.55 to 0.81; I-squared=46.1%) and as a result of DRMR, 100 g of citrus fruit intake per day inhibits CGC by 40% (relative risk, 0.60; 95% CI, 0.44 to 0.83).

Conclusions:: It is suggested that the intake of citrus fruit inhibits the development of CGC. This conclusion can be used as a primary prevention measure in the future when the incidence of CGC may be on the rise.

No MeSH data available.