Stomach cancer is the second common cancer with a poor survival rate in the world. Previous epidemiological studies on stomach cancer indicated the role of environmental factors playing in the development of the disease. These factors include cigarette smoking, alcohol consumption, dietary intake, Helicobacter pylori infection. In addition, Epstein Barr virus (EBV) is also found to be related to stomach cancer. The aims of this study are to illustrate the relationships between socioeconomic status, cigarette smoking, alcohol consumption, EBV and stomach cancer. A cohort with 13,154 men and 3,521 women from 12 townships in Taiwan were recruited from October, 1982 to January, 1986. The 12 townships encompass areas with representative metropolitan precincts, urban and rural townships in the north, middle, and south of Taiwan. Cox’s proportional hazards regression model was used to estimate relative risks of stomach cancer. An average incidence rate of stomach cancer was 60 per 100,000 person-years after a total of 16,675 subjects were followed up for 16 years. The risk of stomach cancer increased with age. Higher education levels had decreased risks of stomach cancer. Cigarette smokers had a 1.5-fold risk of stomach cancer compared with non-smokers; but not had alcohol consumer. Young age started, long-term and heavy smokers had significantly accelerated risks. One interesting result was that subjects with positive IgA antibodies against EBV capsid antigen had a moderate risk of stomach cancer, but not significant. We suggest since the biological mechanisms of cigarette smoking and EBV in stomach cancer development are still unclear, further studies are needed to clarify these mechanisms.

[Proc Amer Assoc Cancer Res, Volume 45, 2004]