Search Results (310)

Helicobacter pylori infection is a major cause of gastric cancer, and eradication before advanced precancerous gastric changes develop provides a biologically plausible opportunity for primary prevention. Adolescence represents a strategically favorable, although not universally established, window for intervention in Japan because persistent childhood-acquired infection can be identified before extensive mucosal damage while school-based programs provide organized access to defined birth cohorts. This narrative review evaluates the evidence supporting population-based adolescent H. pylori screening, its potential harms and uncertainties, and the lessons derived from Japanese implementation. Representative programs demonstrate that organized screening is feasible but show substantial heterogeneity in participation, diagnostic pathways, antimicrobial resistance, eradication outcomes, and retention across the care cascade. Direct evidence that adolescent screening reduces future gastric cancer incidence or mortality is not yet available. As H. pylori prevalence declines, the balance among screening yield, diagnostic performance, antimicrobial exposure, cost, and equity will continue to change. International experience further indicates that prevention strategies should be matched to local epidemiology and healthcare systems. Adolescent screening should therefore be viewed as an adaptive prevention strategy whose target population, diagnostic pathway, and treatment approach require periodic reassessment. Full article

Background/Objectives: H. pylori is the main preventable risk factor for gastric cancer through the development of extensive precancerous lesions, namely mucosal atrophy and intestinal metaplasia. Methods: This multicenter, nationwide study enrolled consecutive patients who underwent their first upper gastrointestinal endoscopy with standard biopsies. Clinical, endoscopic and histological data were gathered for statistical analysis using both univariate and multivariate analyses. Results: Data from 775 patients were collected, and H. pylori infection was detected in 172 (22.2%) cases. The infection prevalence significantly increased with age, and it was significantly higher in patients aged ≥50 years compared to younger patients (26.2% vs. 13.7%; p < 0.001; OR: 2.23; 95% CI = 1.48–3.36). The prevalence of extensive gastric precancerous lesions was 2.6%. The multivariate analysis showed that H. pylori infection (OR: 4.77; 95% CI = 1.51–15; p = 0.007), family history of gastric cancer (OR: 4.86; 95% CI = 1.36–15; p = 0.007), and age (OR: 1.07; 95% CI = 1.02–1.13; p = 0.007) independently increased the risk of these lesions. Conclusions: Data provided by this large study on the endoscopic prevalence of both H. pylori infection and extensive precancerous lesions in the stomach may be useful for designing preventive strategies aimed at reducing gastric cancer mortality. Full article

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection and the primary etiological agent of cervical cancer. Despite the high global disease burden, the Middle East and North Africa (MENA) region faces substantial challenges in HPV prevention and control. This narrative review aimed to synthesize existing evidence on the prevalence, genotypic distribution, awareness, vaccination status, clinical outcomes, and the role of HPV in non-cervical malignancies in the MENA region. Methods: PubMed, Web of Science, Scopus, and Google Scholar were searched, and 122 studies were included. Findings were synthesized qualitatively and descriptively. Cohort studies, systematic reviews, and meta-analyses were prioritized to support inferences about associations and potential causal relationships. Results: HPV prevalence in the general female population of the MENA region ranged from 4.7% to 53.3%, exceeding 90% in high-risk groups and patients with malignancies. The most common genotypes were HPV16 and HPV18; however, distribution patterns varied across populations. Key risk factors included younger age, multiple sexual partners, early age at first sexual intercourse, smoking, and alcohol consumption. General awareness was low to moderate, and vaccination coverage was very low in most countries. Barriers included lack of knowledge, fear of side effects, religious concerns, and social stigma. Evidence also indicates an association between HPV and non-cervical malignancies (head and neck, esophageal, gastric, breast, and thyroid cancers), with HPV DNA detected in tumor tissues. Conclusions: HPV poses a significant public health challenge in the MENA region, characterized by high prevalence, genotypic diversity, limited knowledge and awareness, and unsatisfactory vaccination coverage. Expanding screening and vaccination through financial support, culturally and religiously appropriate education, and longitudinal studies to monitor genotypic changes and associations with other malignancies are essential measures to reduce the burden of HPV-related diseases in the region. Full article

Background/Objectives: Gastric cancer (GC) remains a major global health challenge, highlighting the need for safe and effective bioactive compounds for prevention and treatment. Although 10-hydroxy-2-decenoic acid (10-HDA)—a distinctive bioactive fatty component of royal jelly—has demonstrated anticancer activity in several malignancies, its efficacy and underlying mechanisms in GC remain poorly understood. In the present study, the anticancer activity of 10-HDA was systematically investigated in human GC MKN-45 cells. Methods: MKN-45 cells were treated with 10-HDA across a concentration range of 0.09–1.50 mM. Cell viability, proliferation, and clonogenic growth were evaluated using MTT, scratch wound assay, and colony formation assays. Apoptosis was analyzed by flow cytometry and Western blotting. To explore the underlying molecular mechanisms, transcriptome analysis was conducted, and the results were further validated using flow cytometry, qRT-PCR, and Western blotting. Results: Treatment with 10-HDA significantly inhibited cell viability, proliferation, and clonogenic growth in a dose- and time-dependent manner, with IC₅₀ values of 1.24 ± 0.15 mM, 0.96 ± 0.08 mM, and 0.42 ± 0.06 mM at 24 h, 48 h, and 72 h, respectively. Flow cytometric analysis revealed that apoptosis was markedly induced, with the apoptotic rate increasing from 21.3% in control cells to 78.1% following treatment with 1.50 mM 10-HDA. This was accompanied by upregulation of BAX, downregulation of Bcl-2, and increased activation of caspase-3. Transcriptomic profiling identified significant alterations in DNA replication- and cell cycle-related pathways. Consistently, experimental validation demonstrated that 10-HDA induced pronounced G0/G1-phase cell cycle arrest; downregulation of CDK2 and cyclin D1; reduced retinoblastoma protein phosphorylation; and upregulation of the cyclin-dependent kinase inhibitor CDKN1A. Conclusions: These findings demonstrate that 10-HDA suppresses the malignant phenotype of gastric cancer cells by coordinated activation of apoptosis and cell cycle blockade. Although further in vivo studies and pharmacological experiments are required to evaluate its bioavailability and therapeutic potential, this study provides preliminary mechanistic insights into the effects of 10-HDA on gastric cancer cells. Full article

Gastric cancer (GC) remains a major global health challenge, ranking among the most lethal malignancies due to late diagnosis, high tumor heterogeneity, and limited treatment efficacy. The search for safer, nutritionally based adjuncts to conventional therapies is therefore a research priority. Donkey milk (DM), traditionally used as a hypoallergenic substitute for infants, is emerging as a functional food with remarkable bioactivity. Its composition closely resembles human milk, with high levels of bioactive proteins, a favorable polyunsaturated lipid profile, antioxidant vitamins, and immune-supportive minerals. Despite its growing nutraceutical appeal, the anticancer potential of DM in GC has not yet been explored. This study represents the first investigation of DM in human gastric adenocarcinoma (AGS) cells. Using increasing concentrations of whole DM (25–100%), a dose-dependent inhibition of cell viability and migration was observed. Mechanistic insights reveal that DM induces mitochondrial oxidative stress, disrupts cell cycle progression (S/G2 accumulation at 75%, G2 arrest at 100%), and unexpectedly triggers a pro-inflammatory gene signature suggesting stress-driven immunostimulation rather than canonical apoptosis. These findings highlight a non-classical, context-dependent cytotoxic mechanism that distinguishes DM from conventional pro-apoptotic agents. DM may represent a promising nutraceutical candidate for GC management, bridging traditional food resources with modern oncology. By inhibiting hallmark cancer traits while engaging unique immunological pathways, DM offers a sustainable, low-toxicity approach with translational potential. Future studies will focus on the characterization of active components, validation in organoid and animal models, and exploring clinical applications of DM-derived bioactive components in cancer prevention and therapy. Full article

Background/Objectives: Extra virgin olive oil (EVOO), a key component of the Mediterranean diet, has attracted research interest because olive-derived phenolics demonstrate potential anticancer activity in experimental models. This review summarizes evidence concerning whole EVOO, phenolic-enriched EVOO, olive phenolic extracts, and the isolated compounds hydroxytyrosol, oleuropein, oleocanthal, and oleacein. Methods: A structured narrative search of PubMed, Web of Science, ScienceDirect, and Google Scholar was conducted for literature published between 2015 and 2025. Evidence was reviewed for breast, prostate, colorectal, pancreatic, bone, oral, liver, gastric, hematological, and brain cancers. Comparatively limited evidence concerning cervical, endometrial, ovarian, melanoma, non-melanoma skin, and thyroid cancers was summarized separately. Results: The molecular evidence was derived primarily from cell culture and animal studies using isolated phenolics and concentrated extracts. Preclinical studies indicate that EVOO phenolics may demonstrate anticancer activity through multiple mechanisms, including antioxidant activity, anti-inflammatory effects, cell cycle arrest, induction of apoptosis, inhibition of metastasis, anti-angiogenic activity, and modulation of key signaling pathways, such as PI3K/AKT/mTOR, MAPK/ERK, NF-κB, JAK/STAT, Wnt/β-catenin, p53, and epithelial–mesenchymal transition-related pathways. Most molecular and pathway-level evidence was obtained using isolated phenolic compounds in cell culture or animal models, whereas evidence directly examining whole EVOO consumption was largely observational and substantially more limited. Experimental studies also reported that oleocanthal induced lysosomal membrane permeabilization, whereas hydroxytyrosol and oleuropein promoted mitochondria-mediated apoptosis. Furthermore, preclinical combination studies suggested enhanced tumor-cell sensitivity to selected chemotherapeutic, targeted, and immunotherapeutic agents. However, these effects have not been established in patients. Human evidence remains limited mainly to observational dietary associations and small exploratory interventions, with no conclusive demonstration of cancer prevention or therapeutic efficacy. Conclusions: Isolated EVOO-derived phenolic compounds demonstrated promising anticancer mechanisms in preclinical models. However, these results should not be directly extrapolated to dietary EVOO because experimentally administered doses, bioavailability, metabolism, and food-matrix interactions differ substantially from human dietary exposure. Therefore, well-designed studies using chemically characterized EVOO, pharmacokinetic investigations, and controlled human trials are required before dietary or clinical recommendations can be made. Full article

Gastric cancer is among the leading causes of cancer-related deaths worldwide. Modern treatment approaches include nanoparticles (NPs) designed to target cancer cells, which release a therapeutic cargo facilitating the inhibition of their expansion, thereby improving anti-tumor therapies. The success of NPs, created to deliver anticancer agents and biologically active compounds, may depend on selecting the way to target cancer cells. This study focused on examining the effects of NPs made of polylactic acid (PLA) with histamine (His) end groups and loaded with 5-fluorouracil (5-FU), a known anticancer drug (PLA-His-5-FU), on human gastric cancer AGS cells in vitro. The incubation of AGS cells with PLA-His-FU NPs resulted in diminished mitochondrial membrane potential and the induction of cell apoptosis, along with cell cycle arrest and the reduction of cell proliferation. Furthermore, the NPs tested provoked the secretion of pro-inflammatory cytokines tumor necrosis factor alpha (TNF-α) and interleukin (IL)-1β by AGS cells and induced the activation of the nuclear factor kappa B (NF-κB) signaling pathway in THP-1 blue monocytes, which indicates the ability to promote the development of a milieu for the infiltration and activation of immunocompetent cells. NPs did not increase intracellular adhesion molecule (ICAM-1) deposition on AGS cells, thus potentially preventing the distribution of cancer cells. In conclusion, PLA-His-5-FU NPs show promising anticancer activity for gastric cancer AGS cells in vitro, better than PLA-OH-5-FU, and can be used in further in vivo studies to confirm this activity. Full article

Cancer development arises from dynamic interactions between inherited susceptibility and modifiable environmental exposures, among which diet plays a central role. Carotenoids, lipophilic plant-derived pigments including lycopene, α-carotene, and β-carotene, and retinoids, the vitamin A derivatives that regulate gene transcription via retinoic acid receptors (RARs) and retinoid X receptors (RXRs), have been extensively investigated for their chemopreventive and therapeutic potential. This review aims to provide an integrated, mechanism-based synthesis of the roles of lycopene, α- and β-carotene, and retinoids in cancer chemoprevention and to clarify the conditions under which they are most likely to be effective. Beyond summarizing established antioxidant and nuclear-receptor mechanisms, we highlight as a novel emphasis the epigenetic actions of these compounds, including effects on DNA methylation, histone modification, and microRNA regulation, and we integrate these with the well-recognized divergence between dietary and high-dose supplement outcomes. Experimental evidence demonstrates that carotenoids modulate oxidative stress, inflammation, proliferation, apoptosis, angiogenesis, and metastasis through pathways such as Nrf2/ARE, NF-κB, STAT3, Akt/mTOR, MAPK, and Wnt/β-catenin. Lycopene, in particular, exhibits strong antioxidant capacity and multi-target signaling effects, while provitamin A carotenoids additionally influence retinoid-mediated transcriptional programs. Retinoids exert broader differentiation-inducing and antiproliferative effects through direct nuclear receptor signaling and represent one of the few successful differentiation therapies in oncology, most notably in acute promyelocytic leukemia. Epidemiologic studies generally associate higher dietary carotenoid intake with reduced risk of several malignancies, including prostate, breast, lung, colorectal, and gastric cancers. However, randomized trials of isolated high-dose supplementation, particularly β-carotene in smokers, have demonstrated null or harmful effects, highlighting a critical divergence between whole-food dietary patterns and pharmacologic supplementation. In conclusion, carotenoids and retinoids possess biologically plausible anticancer properties, yet their clinical utility remains context dependent. Future research should prioritize biomarker-guided, precision-based strategies, standardized formulations, and whole-food dietary approaches to clarify their role in cancer prevention and treatment. Full article

Chronic atrophic gastritis (CAG) is a pivotal precancerous condition in gastric carcinogenesis, with progression typically following the classic Correa cascade. Although Helicobacter pylori (H. pylori) infection is widely recognized as the principal etiological factor, the persistence of gastric cancer (GC) risk in a subset of patients after successful eradication suggests that gastric microbiota dysbiosis may also contribute to CAG progression. In recent years, high-throughput sequencing technologies have revealed distinct microbial restructuring in patients with CAG, characterized by decreased microbial diversity, depletion of commensal taxa, and enrichment of opportunistic pathogens. These compositional changes are accompanied by metabolic dysfunction, activation of inflammatory signaling pathways, and disruption of immune homeostasis, which may contribute to a microenvironment permissive for precancerous transformation of the gastric mucosa. Probiotics and related microbiome-based therapeutics, including prebiotics, synbiotics, and postbiotics, have emerged as promising adjunctive strategies for H. pylori eradication and disease management. Their beneficial effects are mediated through multiple mechanisms, including remodeling of the microbial community, inhibition of pathogen colonization, modulation of host immune responses, and restoration of mucosal barrier integrity. However, whether these interventions can reverse established atrophic or metaplastic lesions remains unclear. In addition, how strain specificity, dose dependency, and interindividual heterogeneity influence clinical efficacy has yet to be fully elucidated. In this review, we summarize the compositional and functional features of gastric microbiota dysbiosis in patients with CAG, as well as the mechanisms and clinical applications of microbiome-based interventions. We further highlight current limitations in the field and discuss future directions for precision microecological therapies integrating multi-omics approaches, engineered probiotics, and artificial intelligence. These advances may provide a theoretical framework and practical guidance for the diagnosis and management of CAG and the prevention of GC. Full article

Objectives: The incidence of distal gastric cancer has declined worldwide owing to successful Helicobacter pylori eradication and improvements in environmental and dietary factors. In contrast, adenocarcinoma of the esophagogastric junction (AEG) and proximal gastric cancer have become increasingly prevalent, creating a growing need for function-preserving surgical approaches. Proximal gastrectomy has emerged as an attractive alternative to total gastrectomy because of its potential advantages in nutritional preservation and postoperative quality of life. However, concerns regarding postoperative reflux esophagitis have historically limited its widespread adoption. This review aimed to summarize the evolution of reconstruction after proximal gastrectomy and evaluate the advantages, limitations, and clinical outcomes of contemporary reconstruction techniques. Methods: A narrative review of the current literature was performed, focusing on reconstruction strategies following proximal gastrectomy. Major contemporary techniques, including double-tract reconstruction (DTR), double-flap reconstruction (DFT; Kamikawa method), side-overlap fundoplication by Yamashita (SOFY), and Toupet-like fundoplication reconstruction, were reviewed. Comparative evidence regarding reflux control, nutritional outcomes, operative complexity, anastomotic complications, and postoperative quality of life was examined. Results: Substantial advances in reconstructive techniques have significantly improved functional outcomes after proximal gastrectomy. DTR provides reliable reflux prevention, reproducibility, and broad applicability in minimally invasive surgery. DFT achieves excellent anti-reflux efficacy while preserving physiological food passage through the remnant stomach. SOFY offers favorable functional outcomes with reduced technical complexity and is particularly suited to laparoscopic and robotic surgery. Toupet-like reconstruction represents a promising alternative with encouraging early clinical results. Comparative studies indicate that all contemporary anti-reflux reconstruction methods substantially reduce reflux esophagitis compared with conventional esophagogastrostomy. Although each technique demonstrates specific advantages and limitations, no single reconstruction method has consistently shown superiority across all clinically relevant outcomes, including reflux prevention, nutritional preservation, operative complexity, and quality of life. Conclusions: Modern reconstruction techniques have expanded the role of proximal gastrectomy as a function-preserving alternative to total gastrectomy for proximal gastric cancer and AEG. Current evidence suggests that DTR, DFT, SOFY, and Toupet-like reconstruction can all achieve satisfactory oncological and functional outcomes when appropriately applied. Rather than identifying a universally superior procedure, contemporary practice should emphasize individualized reconstruction based on patient characteristics, surgeon expertise, and institutional experience. Future advances in robotic surgery, perioperative care, and standardized outcome assessment are expected to further optimize long-term outcomes following proximal gastrectomy. Full article

Background/Objectives: Gastric cancer is a major cause of morbidity and mortality in Saudi Arabia, where late-stage presentation is common. Public awareness of risk factors and warning symptoms is essential for early detection. This study assessed gastric cancer knowledge and its demographic correlates among adults in Jeddah. Methods: A cross-sectional survey of 1400 adults was conducted between August and October 2025 using a structured 45-item questionnaire covering 37 knowledge items across four domains. Analyses used independent t-tests, one-way ANOVA, chi-squared tests, and multivariable linear regression. Results: The mean age was 31.34 ± 10.18 years; 53.8% were women. The mean total knowledge score was 18.94 ± 7.34/37 (51.2%). Domain scores were risk factors 4.95 ± 2.04/11 (45.0%), symptoms 4.54 ± 2.87/10 (45.4%), prevention 4.91 ± 2.09/10 (49.1%), and management 2.99 ± 1.95/6 (49.8%). Knowledge was associated with occupation (p < 0.001), with healthcare workers scoring highest (25.97 ± 5.56). Higher knowledge was also associated with education (p < 0.001), age (p = 0.003), and family or friend history of gastric cancer (p = 0.003), but not sex (p = 0.39). In multivariable analysis, educational attainment (β = 0.30) and healthcare-provider occupation (β = 0.23) were the strongest independent correlates of knowledge (both p < 0.001). Only 34% of respondents identified Helicobacter pylori as a risk factor. Conclusions: Awareness of gastric cancer in Jeddah is suboptimal, particularly for risk factors and symptom recognition. Targeted interventions addressing risk factors, alarm symptoms, and dietary risks—delivered through primary care and community channels—may improve awareness and support earlier detection. Full article

Background/Objectives: Standard gastrectomy with lymph node dissection up to D1+ achieves good oncologic control for early gastric cancer not amenable to endoscopic submucosal dissection, yet it frequently leads to post-gastrectomy syndromes and long-term nutritional impairment. Local resection of the stomach reduces post-gastrectomy syndrome; however, the extent of lymph node dissection should be limited beyond D1+ in such cases. This review evaluates the safety of local resection for early gastric cancer reported in East Asia. Methods: We reviewed current concepts and clinical evidence regarding (i) the limitations of preoperative nodal staging, (ii) sentinel node biopsy and function-preserving gastrectomy, and (iii) functional outcomes and procedure-specific complications following local resection, with a focus on delayed gastric emptying. Results: Conventional imaging and biomarkers are inadequate for reliable preoperative identification of node-negative disease. Conversely, sentinel node biopsies demonstrate high intraoperative diagnostic accuracy. Large prospective studies have revealed that, when indications are strictly adhered to, sentinel node biopsy-guided function-preserving gastrectomy can yield survival outcomes comparable to those of standard gastrectomy. The indications for local resection include solitary submucosal tumors below 4 cm in size, diagnosed as node-negative by sentinel node biopsy. Although the available quality-of-life data are generally favorable, there is risk of delayed gastric emptying in local resection with limited lymph node dissection in cases of early gastric cancer. Postoperative gastric deformity following closure was identified as the primary cause. Conclusions: Local resection for submucosal gastric cancer guided by sentinel node biopsy may be oncologically acceptable and function-preserving; however, the prevention of gastric deformity is crucial for its safe implementation. Full article

Helicobacter pylori (H. pylori) infection is closely associated with the development of chronic gastritis, peptic ulcers, and gastric cancer, highlighting the importance of rapid and accurate detection for disease prevention and clinical management. In this study, a one-pot LAMP-CRISPR/Cas12b assay targeting the CagA gene was developed for H. pylori detection. First, the LAMP system was optimized by systematically screening key reaction components. Subsequently, a one-step LAMP-CRISPR/Cas12b detection platform was established through optimization of the ratio between the LAMP premix and CRISPR buffer, reaction temperature, Cas12b concentration, and ssDNA reporter concentration. Under optimal conditions, the assay achieved a detection limit of 3.14 × 10¹ copies/µL, representing a tenfold improvement in sensitivity compared with conventional LAMP and PCR assays (3.14 × 10² copies/µL). In addition, the entire detection process could be completed within 1 h. Validation using 17 culture-positive and 17 culture-negative samples demonstrated complete concordance with culture-based results, with no false-positive or false-negative detections observed. These findings indicate that the proposed platform possesses high sensitivity, excellent specificity, rapid turnaround, and operational simplicity, demonstrating strong potential for point-of-care testing and applications in resource-limited settings. Full article

Background: Esophagectomy remains the definitive curative treatment for esophageal cancer but is historically burdened by significant procedure-related morbidity. Anastomotic leakage (AL) is still the “Achilles’ heel” of esophageal surgery, serving as a primary benchmark for surgical quality due to its profound impact on patient recovery, healthcare costs, and long-term oncological outcomes. While surgical expertise and perioperative care have matured, reported AL rates remain persistently high. This necessitates a shift in focus from purely technical modifications toward integrated, data-driven preventive strategies. Purpose: Five years after our initial review, this update synthesizes the rapid evolution in AL prevention. We evaluate the transition from empirical surgical pragmatism to evidence-based protocols, integrating recent breakthroughs in real-time perfusion monitoring, prophylactic endoluminal technologies, and multidisciplinary patient optimization. This work provides a contemporary “roadmap” for navigating the complexities of esophageal reconstruction. Conclusions: The prevention of AL has evolved into a multimodal “bundle” that begins well before the index operation. This review highlights the critical shift toward quantitative perfusion assessment via indocyanine green fluorescence angiography, which is increasingly replacing subjective visual inspection as the standard for anastomotic site selection. We discuss the emerging role of gastric ischemic preconditioning as a biological strategy to enhance conduit vascularity, alongside the paradigm of proactive management using preemptive endoluminal vacuum therapy to mitigate septic sequelae in high-risk cases. Furthermore, we examine technical refinements in conduit construction and conditioning—focusing on the ‘tension-perfusion’ relationship—and the essential role of structured prehabilitation within enhanced recovery after surgery frameworks. While the quality of evidence remains heterogeneous, the move toward standardized reporting and objective monitoring marks a new era of precision in esophageal surgery. Full article

Background/Objectives: Lycopene, a red lipophilic carotenoid hydrocarbon pigment found primarily in tomatoes and other red/pink fruits and vegetables, has anti-inflammatory, anticarcinogenic and cardioprotective properties. There is a lack of evidence regarding the effect of lycopene intake on gastric cancer risk in the Asian population. We, thus, evaluate the association between lycopene intake and gastric cancer risk in a hospital-based case–control study, including 1182 incident cases of gastric cancer and 2995 controls in Vietnam. Methods: Lycopene intake was derived from a semi-quantitative, validated food frequency questionnaire. An unconditional logistic regression model was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for gastric cancer risk in relation to lycopene intake, adjusted for potential confounding factors. Results: Overall, there was a dose–response inverse association between lycopene intake and gastric cancer risk (OR_{per-SD increment} = 0.88, 95% CI: 0.81–0.95; P_trend = 0.002). Compared with quintile 1 (the lowest quintile), the ORs and 95% CIs of gastric cancer for quintiles 2, 3, 4 and 5 of the lycopene intakes were 0.63 (0.51–0.79), 0.64 (0.51–0.80), 0.65 (0.52–0.81) and 0.62 (0.50–0.78), respectively. A similar pattern of inverse association between lycopene intake and gastric cancer risk was seen only in females, ever alcohol drinkers, and individuals with H. pylori negative status, without type 2 diabetes and with blood group B (all P_{heterogeneity} > 0.05). Conclusions: We observed a reduced risk of gastric cancer in individuals with higher lycopene intake in the Vietnamese population, regardless of BMI or smoking status. Our results have great implications for a healthy dietary pattern (i.e., lycopene with major sources from fruits and vegetables) for strategies in the prevention and control programs of gastric cancer in low-and middle-income countries. Full article