Nitrosamine and related food intake and gastric and oesophageal cancer risk: a systematic review of the epidemiological evidence
To study the association between nitrite and nitrosamine intake and gastric cancer (GC), between meat and processed meat intake, GC and oesophageal cancer (OC), and between preserved fi sh, vegetable and smoked food intake and GC.
In this article we reviewed all the published cohort and case-control studies from 1985-2005, and analyzed the relationship between nitrosamine and nitrite intake and the most important related food intake (meat and processed meat, preserved vegetables and fish, smoked foods and beer drinking) and GC or OC risk. Sixty-one studies, 11 cohorts and 50 case-control studies were included.
Evidence from case-control studies supported an association between nitrite and nitrosamine intake with GC but evidence was insufficient in relation to OC. A high proportion of case-control studies found a positive association with meat intake for both tumours (11 of 16 studies on GC and 11 of 18 studies on OC). A
relatively large number of case-control studies showed quite consistent results supporting a positive association
between processed meat intake and GC and OC risk (10 of 14 studies on GC and 8 of 9 studies on OC).
Almost all the case-control studies found a positive and signifi cant association between preserved fi sh, vegetable
and smoked food intake and GC. The evidence regarding OC was more limited. Overall the evidence from cohort
studies was insuffi cient or more inconsistent than that from case-control studies.
The available evidence supports apositive association between nitrite and nitrosamine intake and GC, between meat and processed meat intake
and GC and OC, and between preserved fish, vegetable and smoked food intake and GC, but is not conclusive.