The largest genome-wide association study (GWAS) of gastric cancer in the Chinese population shows that genetic risk and lifestyle are the two major factors leading to the high incidence of gastric cancer in Chinese people.

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Two Major Factors And Prevention Methods For
Gastric Cancer
Gastric cancer, also known as stomach cancer, is a cancer that develops from the
lining of the stomach. Most cases of stomach cancers are gastric carcinomas, which can
be divided into a number of subtypes including gastric adenocarcinomas.
China is the country with the largest number of incidences and deaths from gastric
cancer in the world. According to the latest global cancer data released by the World
Health Organization International Agency for Research on Cancer (WHO IARC) in 2020,
there are 1.089 million new cases of gastric cancer worldwide and 0.768 million deaths in
2020. There are 478,000 new cases of gastric cancer (43.9%) and 373,000 deaths from
gastric cancer (48.5%) in China.
China has 20 percent of the world's population, but it accounts for about half of the
new cases and deaths of stomach cancer.
So, what are the main reasons for the high incidence of gastric cancer in China? How to
prevent it?
In October 2020, researchers from Nanjing Medical University, Peking University, Fudan
University and Shandong First Medical University Affiliated Tumor Hospital, etc. published
a research paper titled: Genetic risk, incident gastric cancer, and healthy lifestyle: a

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meta-analysis of genome-wide association studies and prospective cohort study in The
Lancet-Oncology.
The largest genome-wide association study (GWAS) of gastric cancer in the Chinese
population shows that genetic risk and lifestyle are the two major factors leading to
the high incidence of gastric cancer in Chinese people.
More importantly, a good lifestyle (no smoking, no drinking, eating less pickled food,
eating more fresh fruits and vegetables) can significantly reduce the risk of gastric cancer
in people with a high genetic risk of gastric cancer, which also reminds us a good lifestyle
and genetic screening of gastric cancer can effectively prevent and treat gastric cancer.
Genetic variation and lifestyle are related to the risk of gastric cancer, but the extent to
which a healthy lifestyle can offset the genetic risk of gastric cancer is still unknown.
Therefore, the research team hopes to evaluate the benefits of a healthy lifestyle for
individuals with high genetic risk by establishing a genetic risk model for gastric cancer.
In this meta-analysis and prospective cohort study, the research team first conducted a
case-control study design in six independent GWAS, and performed a fixed-effect
meta-analysis of the association between genetic variation and gastric cancer.
The meta-analysis data covers 21168 individuals of Han nationality, including 10254
patients with gastric cancer and 10914 cancer-free controls. The research team identified
764 genetic variants that are significantly related to gastric cancer risk from about 7 million
genetic variants, and constructed 5 gastric cancer polygenic risk scores with different
significance thresholds (539 SNP, 112 SNP, and 38 SNP, 18 SNP, 12 SNP).
Then, the research team compared these analysis data with the China Kadoorie Biobank
(CKB), which is an independent, nationwide, and prospective cohort study. Through a
prospective follow-up of 100,220 people for more than 10 years, the effectiveness of the
polygenic risk score and the impact of a healthy lifestyle on the risk of gastric cancer were
evaluated.
A healthy lifestyle includes four points: no smoking, no drinking alcohol, eating less
pickled foods, eating more fresh fruits and vegetables. Achieving these 4 points is
considered as a good lifestyle, those who achieve 2-3 points are considered as an
ordinary lifestyle, and those who can only achieve 1 point or none are considered as poor
lifestyles.
The analysis results showed that the five types of gastric cancer polygenic risk scores
established by meta-analysis were significantly related to the risk of gastric cancer, and
the polygenic risk score model of 112 SNP was most significantly associated with the risk
of gastric cancer.

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Genetic risk and gastric cancer risk
For genetic risk, those with moderate genetic risk had a 54% increased risk of developing
gastric cancer, compared with those with the lowest genetic risk in 20%. Those with the
highest genetic risk of stomach cancer had a 108% increased risk. That is to say, the
higher the genetic risk of gastric cancer, the higher the risk of gastric cancer.
Lifestyle and gastric cancer risk
In terms of living habits, compared with people with healthy lifestyles, people with an
average lifestyle have a 34% increase in gastric cancer risk, while people with a poor
lifestyle have a 103% increase in gastric cancer risk. In other words, as the degree of poor
lifestyle increases, the risk of gastric cancer also increases.

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The benefits of sticking to a healthy lifestyle
The study also found that even with a high genetic risk of gastric cancer, if you can stick to
a healthy lifestyle, that is, no smoking, no drinking, eating less pickled foods, and eating
more fresh fruits & vegetables, the risk of gastric cancer will be reduced by 47%.
For people with low, medium, and high genetic risk of gastric cancer, if they adhere to a
healthy lifestyle, the 10-year absolute risk of gastric cancer is reduced respectively by
0.82%, 0.94%, and 1.12%.
How to prevent gastric cancer
This largest GWAS of gastric cancer for the Chinese population shows that genetic factors
and lifestyle factors are two major factors that are independently related to the risk of
gastric cancer.
The study clearly shows that people with high genetic risk of gastric cancer have a higher
incidence, and people with poor lifestyles also increase the incidence of gastric cancer.
For those with high genetic risk, adhering to a good lifestyle can significantly offset their
risk of gastric cancer.
This also reminds us that sticking to a good lifestyle can prevent gastric cancer, and those
people with a high genetic risk of gastric cancer should be screened in time for early
detection, which can greatly increase the therapeutic effect of gastric cancer and prolong
survival.

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Reference:
Genetic risk, incident gastric cancer, and healthy lifestyle: a meta-analysis of genome-wide association
studies and prospective cohort study