Tobacco smoking and gastric cancer: meta-analyses of published data versus pooled analyses of individual participant data (StoP Project)

Stefania Boccia, Roberta Pastorino, Ana Ferro, Samantha Morais, Matteo Rota, Claudio Pelucchi, Paola Bertuccio, Rossella Bonzi, Carlotta Galeone, Zuo-Feng Zhang, Keitaro Matsuo, Hidemi Ito, Jinfu Hu, Kenneth C. Johnson, Guo-Pei Yuo, Domenico Palli, Monica Ferraroni, Joshua Muscat, Reza Malekzadeh, Weimin YeHuan Song, David Zaridze, Dmitry Maximovitch, Nuria Aragonés, Gemma Castaño-Vinyals, Jesus Vioque, Eva M. Navarrete-Muñoz, Mohammadreza Pakseresht, Farhad Pourfarzi, Alicja Wolk, Nicola Orsini, Andrea Bellavia, Niclas Håkansson, Robert C. Kurtz, Mohammad H. Derakhshan, Areti Lagiou, Pagona Lagioul, Paolo Boffetta, Eva Negri, Carlo La Vecchia, Bárbara Peleteiro, Nuno Lunet

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Tobacco smoking is one of the main risk factors for gastric cancer, but the magnitude of the association estimated by conventional systematic reviews and meta-analyses might be inaccurate, due to heterogeneous reporting of data and publication bias. We aimed to quantify the combined impact of publication-related biases, and heterogeneity in data analysis or presentation, in the summary estimates obtained from conventional meta-analyses. We compared results from individual participant data pooled-analyses, including the studies in the Stomach Cancer Pooling (StoP) Project, with conventional meta-analyses carried out using only data available in previously published reports from the same studies. From the 23 studies in the StoP Project, 20 had published reports with information on smoking and gastric cancer, but only six had specific data for gastric cardia cancer and seven had data on the daily number of cigarettes smoked. Compared to the results obtained with the StoP database, conventional meta-analyses overvalued the relation between ever smoking (summary odds ratios ranging from 7% higher for all studies to 22% higher for the risk of gastric cardia cancer) and yielded less precise summary estimates (SE ≤2.4 times higher). Additionally, funnel plot asymmetry and corresponding hypotheses tests were suggestive of publication bias. Conventional meta-analyses and individual participant data pooled-analyses reached similar conclusions on the direction of the association between smoking and gastric cancer. However, published data tended to overestimate the magnitude of the effects, possibly due to publication biases and limited the analyses by different levels of exposure or cancer subtypes.
Original languageEnglish
Pages (from-to)197-204
Number of pages8
JournalEuropean Journal of Cancer Prevention
Volume27
DOIs
Publication statusPublished - 2018

Keywords

  • Humans
  • Publication Bias
  • Risk Factors
  • Stomach Neoplasms
  • Tobacco Smoking

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