Gastric cancer and salt preference: a population-based cohort study in Korea

Background: Although the incidence of gastric cancer is declining, it remains the most common cancer in Korea. There have been discrepancies in epidemiologic studies regarding a causal relation between highly salted food and the risk of gastric cancer. Objective: The aim of this study was to assess the effect of salt preference on the incidence of gastric cancer in Korean adults through a population-based, prospective cohort study. Design: Participants were Korean government employees, school faculty members, and their unemployed dependents, aged 30-80 y, who underwent health examinations between 1996 and 1997. In 2003, information on the gastric cancer incidence in these participants was obtained during the 6-7-y follow-up period. The final data analysis included 2,248,129 study subjects. The hazard ratio (HR) and 95% CI of the HR were estimated by using the Cox proportional hazards regression model. Results: The age-standardized incidence rates per 100,000 person-years for the overall total population, men only, and women only were 97.64, 136.03, and 52.90, respectively. The Cox proportional hazards regression model, with adjustment for possible confounding factors, showed evidence of an increased risk of gastric cancer with salt preference. The HRs were 1.10 (95% CI: 1.04, 1.16) and 1.10 (95% CI: 1.03, 1.17) for the overall total population and men only, respectively. Conclusion: The current findings suggest that salt preference has a marginal positive association with a risk of gastric cancer. Am J Clin Nutr 2010; 91: 1289-93.