Differences in the Association Between Modifiable Lifestyle Factors and Gastric Precancerous Lesions Among Mongolians and Han Chinese

BackgroundThere has been a paucity of evidence examining whether preventable behavioral risk factors led to ethnic differences of gastric precancerous lesions (GPL). We aimed to investigate the ethnic disparity of associations between GPL and lifestyle factors in Mongolian and Han Chinese populations. MethodsThe study included participants aged 36-75 years enrolled in the Cancer Screening Program during 2016-2017 in Hohhot and Tongliao City, Inner Mongolia. GPL was defined as the gross cascading events (i.e., gastric ulcer, atrophic gastritis, intestinal metaplasia, and dysplasia) that preceded gastric cancer. ResultsA total of 61638 participants were included, of whom 6863(11 center dot 1%) were Mongolians. Alcohol consumption was positively associated with GPL risk in both ethnic groups, but the magnitude was greater in Mongolians (odds ratio (OR) 6 center dot 91, 95%CI 5 center dot 82-8 center dot 28) than in Han Chinese (OR 5 center dot 64, 95%CI 5 center dot 27-6 center dot 04), corresponding to a higher population attributable fraction (PAF) for Mongolians (53 center dot 18% vs 43 center dot 71%). Besides, the strength of the positive association between physical inactivity and GPL risk was greater among Mongolians (OR 2 center dot 02, 95%CI 1 center dot 70-2 center dot 41; OR 1 center dot 09, 95%CI 1 center dot 02-1 center dot 17 among Han Chinese) with a higher PAF. Smoking was strongly associated with GPL risk in both ethnic groups as well, but the association was more prominent among Han Chinese (OR 5 center dot 24 (1 center dot 70-2 center dot 41) for <10 cigarettes/d, 8 center dot 19 (7 center dot 48-8 center dot 97) for 11-20 cigarettes/d, 7 center dot 07 (6 center dot 40-7 center dot 81) for >= 21 cigarettes/d; the corresponding ORs were 2 center dot 96 (2 center dot 19-4 center dot 00), 6 center dot 22 (5 center dot 04-7 center dot 68), and 7 center dot 03 (5 center dot 45-9 center dot 08) among Mongolians). Lastly, our findings revealed that a significant correlation between insufficient fruits and vegetable consumption and GPL risk was only found among Mongolians (OR 1 center dot 27, 95%CI 1 center dot 04-1 center dot 56). ConclusionsOur result suggested that high-risk lifestyle factors should be reduced, particularly in Mongolians. Further studies are needed to elucidate the underlying mechanisms and to reduce health disparities in underserved ethnic groups.