Coprevalence of modifiable gastric cancer risk factors and gastric health among Chinese high-risk groups

This study aims to characterise the distribution and co-prevalence patterns of 11 modifiable gastric cancer (GC) risk factors and to examine their association with gastric health. The research utilised baseline data from the upper gastrointestinal cancer (UGC) screening, early detection and treatment project, as well as the oesophageal cancer prospective cohort in Yangzhong City, spanning 2017-2023. The study sample comprised 12,071 adults aged 40-69 who had completed the screening process, had all relevant study variables, and had no prior history of cancer or upper gastrointestinal surgery. The 11 modifiable GC risk factors (regular smoking, drinking, inadequate intake of vegetables and fruit, intake of red meat and its products, pickled food consumption, irregular diet, fried food consumption, leftover food consumption, eating too quickly, high-salt diet, and Helicobacter pylori infection), and pathologically diagnosed gastric diseases were assessed. Co-prevalence of risk factors was observed in 97.90% of participants. The most prevalent risk factor in both genders was inadequate intake of vegetables and fruit, followed by consumption of red meat and its products. The most common combinations of risk factors include inadequate intake of vegetables and fruit, consumption of red meat and its products, pickled food, and leftover food. An incremental increase in the number of these risk factors corresponded to a significant elevation in the risk of gastric disease, ranging from 8.3 to 9.3% (men: adjusted odds ratio [AOR] 1.093, 95% confidence interval [CI] 1.053-1.134; women: AOR 1.083, 95% CI 1.041-1.128). Participants with more risk factors were more likely to have gastric disease than those with 0-2 risk factors (men with 3-5 risk factors: AOR 1.576, 95% CI 1.217-2.042; men with ≥ 6 risk factors: AOR 1.756, 95% CI 1.344-2.295; women with ≥ 6 risk factors: AOR 1.449, 95% CI 1.162-1.806). Our study reveals significant differences in the prevalence of 11 modifiable GC risk factors among individuals at high risk for UGC in Yangzhong City, and these risk factors exhibit significant co-prevalence. Individuals with more risk factors typically experience poorer gastric health. Therefore, it is crucial to implement comprehensive interventions to enhance public awareness of GC-related knowledge, beliefs, and behaviours. Simultaneously, effectively identifying high-risk groups and providing tailored interventions during screening are essential for improving gastric health.