REGIONAL RISK-FACTORS FOR STOMACH-CANCER IN THE FRG

A multicentric, hospital-based, case-control study was conducted in high- and low-risk areas for stomach cancer in the Federal Republic of Germany, by which means a low intake of dietary vitamin C (relative risk [RR] = 2.32, 95% confidence interval [CI] 1.22-4.43 for lowest against highest quintile), noncentralized water supply (RR = 2.17, CI 1.14-4.13 against central water supply), refrigerator use for less than 25 years (RR = 1.33, CI 0.82-2.15 against more than 30 years), and the use of spruce for smoking meat at home (RR = 3.33, CI 1.56-7.12 against not smoking meat at home), were identified as factors potentially causally related to stomach cancer occurrence. The attributable risk for gastric carcinoma among the population (AR(p)) was 37.5% for low vitamin C intake, 37.2% for noncentralized water supply, 10.6% for late refrigerator use, and 4.15% for use of spruce for smoking meat at home in this analysis. The overall AR(p) amounted to 68.3%. These personally linked factors also showed a strong regional distribution, in that the low-risk area had more favorable categories of exposure. Traditional nutritional habits around 1910 were recorded during a survey by ethnologists in 1965. This material was used to contrast those in high and low stomach cancer risk areas with the habits in the south of Germany in general. Vegetable use was most common in the low-risk area, whereas mashed potatoes, cabbage, and farinaceous dishes dominated in the high-risk area. Tomatoes were introduced several years later into the high-risk area, both in terms of consumption and cultivation. Mostly beech wood had been used for smoking meat in the low-risk area, whereas in the other areas different kinds of wood were used, including spruce.