{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:37:10Z","timestamp":1792600630296,"version":"4.5.0"},"reference-count":89,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>This study aimed to investigate the risk of gastric cancer (GC) in abnormal body mass index (BMI) groups. A systematic search was carried out on Embase, PubMed\/Medline, and Scopus from January 2000 to January 2023. The pooled risk ratio (RR) with a 95% confidence interval (CI) was assessed using a random-effect model. Thirteen studies with total of 14,020,031 participants were included in this systematic review. The pooled RR of GC was 1.124 (95% CI, 0.968\u20131.304, I2: 89.08%) in underweight class, 1.155 (95% CI, 1.051\u20131.270, I2: 95.18%) in overweight class, and in 1.218 (95% CI, 1.070\u20131.386, I2: 97.65%) obesity class. There is no difference between cardia and non-cardia gastric cancer, while non-Asian race and female gender have higher risk of cancer, as Meta-regression of obesity and overweight classes showed. These findings suggest that there is a positive association between excess body weight and the risk of GC, with a higher impact in women than men and in non-Asian than Asian populations. Since abnormal weight is tied to various diseases, including GC, healthcare experts, and policymakers should continue interventions aiming to achieve a normal BMI range.<\/jats:p>","DOI":"10.3390\/cancers15102778","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T01:58:06Z","timestamp":1684288686000},"page":"2778","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Gastric Cancer Risk in Association with Underweight, Overweight, and Obesity: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2464-2473","authenticated-orcid":false,"given":"Narges","family":"Azizi","sequence":"first","affiliation":[{"name":"School of Medicine, Tehran University of Medical Sciences, Tehran 1416634793, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7454-7944","authenticated-orcid":false,"given":"Moein","family":"Zangiabadian","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman 7616913555, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Golnoosh","family":"Seifi","sequence":"additional","affiliation":[{"name":"School of Medicine, Tehran University of Medical Sciences, Tehran 1416634793, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshan","family":"Davari","sequence":"additional","affiliation":[{"name":"School of Medicine, Tehran University of Medical Sciences, Tehran 1416634793, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Yekekhani","sequence":"additional","affiliation":[{"name":"School of Medicine, Tehran University of Medical Sciences, Tehran 1416634793, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9295-9283","authenticated-orcid":false,"given":"Seyed Amir Ahmad","family":"Safavi-Naini","sequence":"additional","affiliation":[{"name":"Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7086-9885","authenticated-orcid":false,"given":"Nathan A.","family":"Berger","sequence":"additional","affiliation":[{"name":"Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3279-0671","authenticated-orcid":false,"given":"Mohammad Javad","family":"Nasiri","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6811-3955","authenticated-orcid":false,"given":"Mohammad-Reza","family":"Sohrabi","sequence":"additional","affiliation":[{"name":"Community Medicine Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran"},{"name":"Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"The global, regional and national burden of stomach cancer and its attributable risk factors from 1990 to 2019","volume":"12","author":"Song","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.5114\/pg.2018.80001","article-title":"Epidemiology of gastric cancer: Global trends, risk factors and prevention","volume":"14","author":"Rawla","year":"2019","journal-title":"Gastroenterol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6114","DOI":"10.1002\/cam4.2497","article-title":"Risk factors predisposing to cardia gastric adenocarcinoma: Insights and new perspectives","volume":"8","author":"Abdi","year":"2019","journal-title":"Cancer Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1093\/jn\/nxz268","article-title":"The World Cancer Research Fund\/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions","volume":"150","author":"Clinton","year":"2020","journal-title":"J. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1136\/gutjnl-2020-321600","article-title":"Global burden of oesophageal and gastric cancer by histology and subsite in 2018","volume":"69","author":"Arnold","year":"2020","journal-title":"Gut"},{"key":"ref_6","first-page":"669","article-title":"Eastern European and Asian-born populations are prone to gastric cancer: An epidemiologic analysis of foreign-born populations and gastric cancer","volume":"34","author":"Kumar","year":"2021","journal-title":"Ann. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1001\/jama.2010.496","article-title":"Age-specific trends in incidence of noncardia gastric cancer in US adults","volume":"303","author":"Anderson","year":"2010","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1093\/jnci\/91.9.747","article-title":"The rising incidence of gastric cardia cancer","volume":"91","author":"Devesa","year":"1999","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"695","DOI":"10.21147\/j.issn.1000-9604.2020.06.03","article-title":"Gastric cancer: Epidemiology, risk factors and prevention strategies","volume":"32","author":"Yang","year":"2020","journal-title":"Chin. J. Cancer Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1080\/17474124.2019.1542299","article-title":"The eradication of Helicobacter pylori to prevent gastric cancer: A critical appraisal","volume":"13","author":"Wu","year":"2018","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Bouras, E., Tsilidis, K.K., Triggi, M., Siargkas, A., Chourdakis, M., and Haidich, A.-B. (2022). Diet and Risk of Gastric Cancer: An Umbrella Review. Nutrients, 14.","DOI":"10.3390\/nu14091764"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12876-020-01551-1","article-title":"Sex difference in the incidence of cardia and non-cardia gastric cancer in the United States, 1992\u20132014","volume":"20","author":"Yao","year":"2020","journal-title":"BMC Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1016\/j.ejca.2008.07.031","article-title":"Oestrogen and the enigmatic male predominance of gastric cancer","volume":"44","author":"Chandanos","year":"2008","journal-title":"Eur. J. Cancer"},{"key":"ref_14","unstructured":"World Health Organization (2021, July 16). Obesity and Overweight. Available online: http:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Dai, H., Alsalhe, T.A., Chalghaf, N., Ricc\u00f2, M., Bragazzi, N.L., and Wu, J. (2020). The global burden of disease attributable to high body mass index in 195 countries and territories, 1990\u20132017: An analysis of the Global Burden of Disease Study. PLoS Med., 17.","DOI":"10.1371\/journal.pmed.1003198"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2020\/6134362","article-title":"Epidemiology, Predisposing Factors, Biomarkers, and Prevention Mechanism of Obesity: A Systematic Review","volume":"2020","author":"Endalifer","year":"2020","journal-title":"J. Obes."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Pati, S., Irfan, W., Jameel, A., Ahmed, S., and Shahid, R.K. (2023). Obesity and Cancer: A Current Overview of Epidemiology, Pathogenesis, Outcomes, and Management. Cancers, 15.","DOI":"10.3390\/cancers15020485"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1002\/msj.20167","article-title":"Type 2 diabetes and cancer: What is the connection?","volume":"77","author":"Cannata","year":"2010","journal-title":"Mt. Sinai J. Med. N. Y."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1002\/1878-0261.12772","article-title":"Physical activity, obesity and sedentary behavior in cancer etiology: Epidemiologic evidence and biologic mechanisms","volume":"15","author":"Friedenreich","year":"2020","journal-title":"Mol. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.gtc.2013.11.009","article-title":"Obesity and GERD","volume":"43","author":"Chang","year":"2014","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1097\/CEJ.0000000000000480","article-title":"Gastric cancer: Epidemiology, biology, and prevention: A mini review","volume":"28","author":"Lyons","year":"2019","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1038\/ijo.2009.45","article-title":"Meat consumption is associated with obesity and central obesity among US adults","volume":"33","author":"Wang","year":"2009","journal-title":"Int. J. Obes."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1002\/ijc.32707","article-title":"Meat intake and risk of gastric cancer in the Stomach cancer Pooling (StoP) project","volume":"147","author":"Ferro","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Thapa, S., Fischbach, L.A., Delongchamp, R., Faramawi, M.F., and Orloff, M. (2019). The Association between Salt and Potential Mediators of the Gastric Precancerous Process. Cancers, 11.","DOI":"10.3390\/cancers11040535"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e0188770","DOI":"10.1371\/journal.pone.0188770","article-title":"Associations of sodium intake with obesity, metabolic disorder, and albuminuria according to age","volume":"12","author":"Oh","year":"2017","journal-title":"PLoS ONE"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S0140-6736(08)60269-X","article-title":"Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies","volume":"371","author":"Renehan","year":"2008","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2867","DOI":"10.1016\/j.ejca.2009.04.019","article-title":"Overweight, obesity and gastric cancer risk: Results from a meta-analysis of cohort studies","volume":"45","author":"Yang","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1093\/jjco\/hyu082","article-title":"Body Mass Index and Risk of Gastric Cancer: A Meta-analysis","volume":"44","author":"Lin","year":"2014","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1158\/1055-9965.EPI-13-0042","article-title":"Body mass index and risk of gastric cancer: A meta-analysis of a population with more than ten million from 24 prospective studies","volume":"22","author":"Chen","year":"2013","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"369","DOI":"10.4143\/crt.2019.241","article-title":"Body Mass Index and Risk of Gastric Cancer in Asian Adults: A Meta-Epidemiological Meta-Analysis of Population-Based Cohort Studies","volume":"52","author":"Bae","year":"2020","journal-title":"Cancer Res. Treat."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1093\/annonc\/mds244","article-title":"A meta-analysis of body mass index and esophageal and gastric cardia adenocarcinoma","volume":"24","author":"Turati","year":"2013","journal-title":"Ann. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","article-title":"Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement","volume":"151","author":"Moher","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13643-017-0663-8","article-title":"Evaluations of the uptake and impact of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement and extensions: A scoping review","volume":"6","author":"Page","year":"2017","journal-title":"Syst. Rev."},{"key":"ref_34","unstructured":"World Health Organization, and Regional Office for the Western P (2000). The Asia-Pacific Perspective: Redefining Obesity and Its Treatment, Health Communications Australia."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1002\/ijc.20529","article-title":"Obesity and risk of cancer in Japan","volume":"113","author":"Kuriyama","year":"2004","journal-title":"Int. J. Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4742","DOI":"10.1200\/JCO.2005.11.726","article-title":"Effects of Excess Weight on Cancer Incidences Depending on Cancer Sites and Histologic Findings Among Men: Korea National Health Insurance Corporation Study","volume":"23","author":"Oh","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1002\/ijc.20616","article-title":"Prospective study of risk factors for esophageal and gastric cancers in the Linxian general population trial cohort in China","volume":"113","author":"Tran","year":"2004","journal-title":"Int. J. Cancer"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/CEJ.0b013e3282f521e4","article-title":"Female reproductive factors and the risk of gastric cancer in a large-scale population-based cohort study in Japan (JPHC study)","volume":"17","author":"Persson","year":"2008","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/CEJ.0b013e3283240460","article-title":"Impact of metabolic factors on subsequent cancer risk: Results from a large-scale population-based cohort study in Japan","volume":"18","author":"Inoue","year":"2009","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s10120-013-0312-4","article-title":"Height, weight, and body mass index associations with gastric cancer subsites","volume":"17","author":"Camargo","year":"2013","journal-title":"Gastric Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/ijc.29411","article-title":"Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study","volume":"137","author":"Buckland","year":"2014","journal-title":"Int. J. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/ijc.29432","article-title":"General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition","volume":"137","author":"Steffen","year":"2015","journal-title":"Int. J. Cancer"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1111\/cas.13292","article-title":"Body mass index and risk of gastric cancer: A 30-year follow-up study in the Linxian general population trial cohort","volume":"108","author":"Fan","year":"2017","journal-title":"Cancer Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1038\/bjc.2017.29","article-title":"Body weight trajectories and risk of oesophageal and gastric cardia adenocarcinomas: A pooled analysis of NIH-AARP and PLCO Studies","volume":"116","author":"Petrick","year":"2017","journal-title":"Br. J. Cancer"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"101622","DOI":"10.1016\/j.canep.2019.101622","article-title":"Effect of body-mass index on the risk of gastric cancer: A population-based cohort study in A Japanese population","volume":"63","author":"Hirabayashi","year":"2019","journal-title":"Cancer Epidemiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"5614","DOI":"10.1002\/cam4.4097","article-title":"A Body Shape Index (ABSI), hip index, and risk of cancer in the UK Biobank cohort","volume":"10","author":"Christakoudi","year":"2021","journal-title":"Cancer Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1002\/cam4.3808","article-title":"Body composition and risk of gastric cancer: A population-based prospective cohort study","volume":"10","author":"Liu","year":"2021","journal-title":"Cancer Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.14309\/ajg.0000000000001355","article-title":"Population Attributable Risks of Subtypes of Esophageal and Gastric Cancers in the United States","volume":"116","author":"Wang","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_49","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Oxford, 2000."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.2307\/2533446","article-title":"Operating characteristics of a rank correlation test for publication bias","volume":"50","author":"Begg","year":"1994","journal-title":"Biometrics"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jclinepi.2021.03.001","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"134","author":"Page","year":"2021","journal-title":"J. Clin. Epidemiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"101683","DOI":"10.1016\/j.canep.2020.101683","article-title":"Body mass index and risk of upper gastrointestinal cancer: A 30-year follow-up of the Linxian dysplasia nutrition intervention trial cohort","volume":"65","author":"Zhang","year":"2020","journal-title":"Cancer Epidemiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1158\/1055-9965.EPI-22-0051","article-title":"Association between Body Mass Index and Risk of Gastric Cancer by Anatomic and Histologic Subtypes in Over 500,000 East and Southeast Asian Cohort Participants","volume":"31","author":"Jang","year":"2022","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1038\/sj.bjc.6602819","article-title":"Obesity and incidence of cancer: A large cohort study of over 145 000 adults in Austria","volume":"93","author":"Rapp","year":"2005","journal-title":"Br. J. Cancer"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/ijc.21354","article-title":"Body mass index and cancer: Results from the Northern Sweden Health and Disease Cohort","volume":"118","author":"Lukanova","year":"2005","journal-title":"Int. J. Cancer"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1158\/1055-9965.EPI-07-0704","article-title":"Body Mass and Physical Activity and Risk of Gastric Cancer in a Population-Based Cohort Study in Norway","volume":"17","author":"Jia","year":"2008","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.ejca.2007.12.009","article-title":"A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma","volume":"44","author":"Abnet","year":"2008","journal-title":"Eur. J. Cancer"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Eom, B.W., Joo, J., Kim, S., Shin, A., Yang, H.-R., Park, J., Choi, I.J., Kim, Y.-W., Kim, J., and Nam, B.-H. (2015). Prediction Model for Gastric Cancer Incidence in Korean Population. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0132613"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1002\/ijc.32386","article-title":"Anthropometric and reproductive factors and risk of esophageal and gastric cancer by subtype and subsite: Results from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort","volume":"146","author":"Sanikini","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Sanikini, H., Muller, D.C., Chadeau-Hyam, M., Murphy, N., Gunter, M.J., and Cross, A.J. (2020). Anthropometry, body fat composition and reproductive factors and risk of oesophageal and gastric cancer by subtype and subsite in the UK Biobank cohort. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0240413"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1002\/ijc.32394","article-title":"Cancer incidence in relation to body fatness among 0.5 million men and women: Findings from the China Kadoorie Biobank","volume":"146","author":"Wang","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2834","DOI":"10.1111\/jgh.15558","article-title":"Association between obesity and the risk of gastric cancer in premenopausal and postmenopausal women: A nationwide cohort study","volume":"36","author":"Choi","year":"2021","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Lee, H.-W., Huang, D., Shin, W.-K., de la Torre, K., Yang, J.J., Song, M., Shin, A., Lee, J.-K., and Kang, D. (2022). Obesity at early adulthood increases risk of gastric cancer from the Health Examinees-Gem (HEXA-G) study. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0260826"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4143\/crt.2021.130","article-title":"Association between the Persistence of Obesity and the Risk of Gastric Cancer: A Nationwide Population-Based Study","volume":"54","author":"Lim","year":"2022","journal-title":"Cancer Res. Treat."},{"key":"ref_66","unstructured":"Higgins, J.P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2023, February 24). Cochrane Handbook for Systematic Reviews of Interventions; Version 6.3 (Updated February 2022). Available online: www.training.cochrane.org\/handbook."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1111\/j.1523-5378.2011.00889.x","article-title":"Low Prevalence of Helicobacter pylori-negative Gastric Cancer among Japanese","volume":"16","author":"Matsuo","year":"2011","journal-title":"Helicobacter"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"212","DOI":"10.5009\/gnl14416","article-title":"Comparison between Resectable Helicobacter pylori-Negative and -Positive Gastric Cancers","volume":"10","author":"Kim","year":"2016","journal-title":"Gut Liver"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1038\/s10038-021-00960-8","article-title":"Lifestyles, genetics, and future perspectives on gastric cancer in east Asian populations","volume":"66","author":"Katoh","year":"2021","journal-title":"J. Hum. Genet."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-022-10014-4","article-title":"The burden and trend of gastric cancer and possible risk factors in five Asian countries from 1990 to 2019","volume":"12","author":"Ning","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1046\/j.1467-789X.2002.00065.x","article-title":"Asians are different from Caucasians and from each other in their body mass index\/body fat per cent relationship","volume":"3","author":"Deurenberg","year":"2002","journal-title":"Obes. Rev."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"(2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363, 157\u2013163.","DOI":"10.1016\/S0140-6736(03)15268-3"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"66","DOI":"10.47102\/annals-acadmedsg.V38N1p66","article-title":"Rationale for redefining obesity in Asians","volume":"38","author":"Low","year":"2009","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1002\/oby.23639","article-title":"Obesity among Asian American people in the United States: A review","volume":"31","author":"Li","year":"2023","journal-title":"Obesity"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/joim.13082","article-title":"Ethnic differences in adiposity and diabetes risk\u2014insights from genetic studies","volume":"288","author":"Yaghootkar","year":"2020","journal-title":"J. Intern. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1093\/ajcn\/86.2.353","article-title":"Visceral adipose tissue accumulation differs according to ethnic background: Results of the Multicultural Community Health Assessment Trial (M-CHAT)","volume":"86","author":"Humphries","year":"2007","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Januszewicz, W., Turkot, M.H., Malfertheiner, P., and Regula, J. (2023). A Global Perspective on Gastric Cancer Screening: Which Concepts Are Feasible, and When?. Cancers, 15.","DOI":"10.3390\/cancers15030664"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Zhang, X., Li, M., Chen, S., Hu, J., Guo, Q., Liu, R., Zheng, H., Jin, Z., Yuan, Y., and Xi, Y. (2018). Endoscopic Screening in Asian Countries Is Associated With Reduced Gastric Cancer Mortality: A Meta-analysis and Systematic Review. Gastroenterology, 155.","DOI":"10.1053\/j.gastro.2018.04.026"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1016\/S2213-8587(18)30150-5","article-title":"Worldwide burden of cancer attributable to diabetes and high body-mass index: A comparative risk assessment","volume":"6","author":"Zhou","year":"2018","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2022\/1269435","article-title":"Sex Disparity in Patients with Gastric Cancer: A Systematic Review and Meta-Analysis","volume":"2022","author":"Luan","year":"2022","journal-title":"J. Oncol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0304-3835(01)00739-X","article-title":"Expression of estrogen receptor-alpha and -beta mRNAs in human gastric cancer","volume":"176","author":"Takano","year":"2002","journal-title":"Cancer Lett."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1007\/s13679-021-00426-0","article-title":"Gender Differences in Obesity-Related Cancers","volume":"10","author":"Argyrakopoulou","year":"2021","journal-title":"Curr. Obes. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1158\/1055-9965.EPI-05-0860","article-title":"Body Mass Index and Adenocarcinomas of the Esophagus or Gastric Cardia: A Systematic Review and Meta-analysis","volume":"15","author":"Kubo","year":"2006","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Du, X., Hidayat, K., and Shi, B.-M. (2017). Abdominal obesity and gastroesophageal cancer risk: Systematic review and meta-analysis of prospective studies. Biosci. Rep., 37.","DOI":"10.1042\/BSR20160474"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"412","DOI":"10.3389\/fmicb.2015.00412","article-title":"Two distinct etiologies of gastric cardia adenocarcinoma: Interactions among pH, Helicobacter pylori, and bile acids","volume":"6","author":"Mukaisho","year":"2015","journal-title":"Front. Microbiol."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Nour, M., Lutze, S.A., Grech, A., and Allman-Farinelli, M. (2018). The Relationship between Vegetable Intake and Weight Outcomes: A Systematic Review of Cohort Studies. Nutrients, 10.","DOI":"10.3390\/nu10111626"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1177\/0193945919858699","article-title":"Fruit and Vegetable Consumption in Overweight or Obese Individuals: A Meta-Analysis","volume":"42","author":"Arnotti","year":"2019","journal-title":"West. J. Nurs. Res."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.2741\/4059","article-title":"Obesity and gastric cancer","volume":"17","author":"Li","year":"2012","journal-title":"Front. Biosci."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1002\/ijc.32790","article-title":"The U-shaped association between body mass index and gastric cancer risk in the Helicobacter pylori Biomarker Cohort Consortium: A nested case\u2013control study from eight East Asian cohort studies","volume":"147","author":"Jang","year":"2019","journal-title":"Int. J. 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