Environmental Science and Pollution Research

, Volume 26, Issue 11, pp 10487–10495 | Cite as

Environmental etiology of gastric cancer in Iran: a systematic review focusing on drinking water, soil, food, radiation, and geographical conditions

  • Hamid Reza Ghaffari
  • Masud YunesianEmail author
  • Ramin Nabizadeh
  • Simin Nasseri
  • Alireza Sadjadi
  • Farhad Pourfarzi
  • Hossein Poustchi
  • Ahad Eshraghian
Review Article


The aim of this systematic review study was to investigate the causal relationship between environmental factors and gastric cancer (GC) in Iran. In a narrow definition, the environment includes water, soil, air, and food. This definition was the main criterion for the inclusion of articles in this study. In addition, exposure to radiation and geographical conditions were considered as less investigated environmental factors in the literatures. International (PubMed, Web of Science, ScienceDirect, Scopus, and Cochran) and national (Scientific Information Database) databases were searched for articles on GC and environmental risk factors in Iran. Twenty-six articles were found to meet the inclusion criteria after title, abstract, and full text review. Risk factors identified for GC include consumption of red meat; high fat, fried, and salted meat; smoked, salted, and fried foods; some dairy products; roasted and fried seeds; strong and hot tea; and un-piped and unchlorinated drinking water, as well as exposure to radiation, loess sediment, soft and grassy soil, soil containing low concentration of molybdenum, and proximity to volcanos. Fresh fruits and vegetable, fresh fish, and honey consumption were recognized as protective agents. Given the risk factors identified, strategies to prevent GC would be educating people to choose a healthy diet and to cook and store food properly, providing access to safe drinking water, taking into account topographical and geographical conditions in choosing a right location to build residential areas, and regulating the use of radiation-emitting devices.


Environment Gastric cancer Water Soil Food Radiation Geographical condition 



This study was conducted as part of Ph.D. thesis of the first author at Tehran University of Medical Sciences, Iran.

Funding information

This study was supported by the Institute for Environmental Research (IER), Tehran University of Medical Sciences (grant number: 96-03-46-36620).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

11356_2019_4493_MOESM1_ESM.docx (107 kb)
ESM 1 (DOCX 106 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Hamid Reza Ghaffari
    • 1
  • Masud Yunesian
    • 1
    • 2
    Email author
  • Ramin Nabizadeh
    • 1
    • 3
  • Simin Nasseri
    • 1
    • 4
  • Alireza Sadjadi
    • 5
    • 6
  • Farhad Pourfarzi
    • 7
  • Hossein Poustchi
    • 5
  • Ahad Eshraghian
    • 8
  1. 1.Department of Environmental Health Engineering, School of Public HealthTehran University of Medical SciencesTehranIran
  2. 2.Center for Air Pollution Research and Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER)Tehran University of Medical SciencesTehranIran
  3. 3.Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER)Tehran University of Medical SciencesTehranIran
  4. 4.Center for Water Quality Research, Institute for Environmental Research (IER)Tehran University of Medical SciencesTehranIran
  5. 5.Digestive Oncology Research Center, Digestive Disease Research InstituteTehran University of Medical SciencesTehranIran
  6. 6.No Way New Way Companythe Haugethe Netherlands
  7. 7.Digestive Disease Research CenterArdabil University of Medical SciencesArdabilIran
  8. 8.Avicenna HospitalAvicenna Center for Medicine and Organ TransplantShirazIran

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