Evidence map›Paper›PMID 40264179›Full record

Trial reportBMC medicine2025

Effect of sodium-reduced potassium-enriched salt substitutes on stomach cancer: the Salt Substitute and Stroke Study (SSaSS).

Xinyi Zhang, Xuejun Yin, Mei Ling Yap, Qiang Li, Liping Huang, Yishu Liu, Bo Zhou, Zhifang Li, Yi Zhao, Jixin Sun and 5 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02092090 (A LARGE-SCALE CLUSTER RANDOMIZED TRIAL TO DETERMINE THE EFFECTS OF SODIUM REDUCTION ON STROKE), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02092090 nacompletednot on this map

A LARGE-SCALE CLUSTER RANDOMIZED TRIAL TO DETERMINE THE EFFECTS OF SODIUM REDUCTION ON STROKE: THE CHINA SALT SUBSTITUTE AND STROKE STUDY (SSaSS)

TypeinterventionalSponsorThe George InstituteRan2014 to 2020Enrolled20,996ConditionsStrokeArmsDietary sodium reduction
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Xinyi Zhang *School of Public Health, Harbin Medical University, Harbin, China.
Xuejun Yin *School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China. xyin@georgeinstitute.org.au.
Mei Ling YapFaculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Qiang LiFaculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Liping HuangFaculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Yishu LiuSchool of Public Health, Nanjing Medical University, Nanjing, China.
Bo ZhouDepartment of Evidence-Based Medicine, First Affiliated Hospital of China Medical University, Shenyang, China.
Zhifang LiSchool of Public Health, Changzhi Medical College, Changzhi, China.
Yi ZhaoSchool of Public Health, Ningxia Medical University, Yinchuan, China.
Jixin SunDepartment of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, China.
Yan YuSchool of Public Health, Jiaotong University Health Science Centre, Xi'an, China.
Lijing L YanGlobal Health Research Centre, Duke Kunshan University, Kunshan, China.
Yangfeng WuSchool of Public Health, Peking University Clinical Research Instituteand, Peking University , Beijing, China.
Bruce NealFaculty of Medicine and Health, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Maoyi TianSchool of Public Health, Harbin Medical University, Harbin, China. maoyi.tian@hrbmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is an association between increased dietary sodium intake and the risk of stomach cancer. Lowering dietary sodium intake with sodium-reduced potassium-enriched salt substitutes may reduce this risk. To evaluate the effects of sodium-reduced potassium-enriched salt substitutes on the risk of stomach cancer and other types of cancer.

methodsThe primary analyses of the Salt Substitute and Stroke Study (SSaSS) defined the effects of sodium-reduced potassium-enriched salt substitutes compared to regular salt on the risk of stroke. This post-hoc investigation explored effects on stomach and other cancers. SSaSS was an open-label, cluster randomised controlled trial done in 600 Chinese villages among 20,996 participants. Villages were assigned at random in a 1:1 ratio to receive sodium-reduced potassium-enriched salt substitutes or continue regular salt use. Fatal and hospitalised cancer events were identified through direct face-to-face follow-up and record linkage, with adjudication of fatal, but not non-fatal events.

resultsDuring a mean follow-up of 4.7 years, there were 1040 cancer events (507 fatal, 533 non-fatal) recorded. There were 212 stomach cancers, 725 other cancers, and 103 cancers with an unknown primary site. There was a trend toward but not a significant effect of randomised treatment on total stomach cancer (rate ratio (RR) 0.77, 95% confidence interval (CI) 0.54 to 1.08). The RR for adjudicated fatal stomach cancer was 0.66 (95% CI 0.44 to 1.00) compared to 0.88 (95% CI 0.56 to 1.37) for unadjudicated non-fatal stomach cancer. There was no detectable effect on total cancer at any site (RR 0.94, 95% CI 0.81 to 1.08), adjudicated fatal cancer at any site (RR 0.85, 95% CI 0.69 to 1.05), or unadjudicated non-fatal cancer at any site (RR 1.04, 95% CI 0.88 to 1.23).

conclusionsThere was no effect of sodium-reduced potassium-enriched salt substitutes on stomach cancer or other cancer types detected. Trends toward protection against fatal and non-fatal stomach cancer align with the observational epidemiology and warrant further investigation.

trial registrationThis trial was registered in ClinicalTrials.gov as NCT02092090.

Indexed as

Sodium Chloride, DietaryStomach NeoplasmsStrokeAdultAgedChinaFemaleFollow-Up StudiesHumansMaleMiddle AgedSodium Chloride, DietaryCluster randomised controlled trialPotassium supplementationSalt substitutesSodium reductionStomach cancer

Identifiers

PMID40264179
PMCPMC12016401

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.