Cigarette Smoking and Other risk Factors for progression of Precancerous Stomach Lesions

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Abstract
Background: Stomach cancer is generally thought to evolve through a series of gastric mucosal changes, but the derterminants of the precancerous lesions are not well understood. purpose : Our purpose was to assess risk factors for intestinal metplasia and gastric dysplasia arising from chronicatrophic gastritis in a genral population at high risk for stomach cancer. Methods : A population-based gastroscopic screening of more than 3000 residents was conducted in a county in china eith one of the world's highest rtes of stomach cancer. Information on the lifestyle and other charateristics of the participants was obtained by interview, and responses were compared between those in whom the most advanced gastric lesion was dysplasiaor intestinal metaplasia versus those with chronic atrophic gastritis. Results : Cigarette smoking was found to nearly double the risk of transition to dysplasia and to be a mild risk factor for intestinal metaplasia. Smoling accounted almost entirely for the 55% higher prevalence of dysplasis among men than among women. Risk of transition to dysplasis had a weak association with several dietary factors and was increased among those participants with a family history of stomach cancer and with blood type A. Conclusions: The findings provide storng evidence for a role of tobacco consumption and offer clues to other enviromental and genetic factord involved in the process of gastric carcinogenesis. (J Natl cancer Inst 84: 1261–1266, 1992]

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