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Review
. 2013 Apr 28;19(16):2560-8.
doi: 10.3748/wjg.v19.i16.2560.

Acid suppressive drugs and gastric cancer: a meta-analysis of observational studies

Jeong Soo Ahn  1 , Chun-Sick Eom, Christie Y Jeon, Sang Min Park
Affiliations
Review

Acid suppressive drugs and gastric cancer: a meta-analysis of observational studies

Jeong Soo Ahn et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the association between acid suppressive drug use and the development of gastric cancer.

Methods: A systematic search of relevant studies that were published through June 2012 was conducted using the MEDLINE (PubMed), EMBASE, and Cochrane Library databases. The search included observational studies on the use of histamine 2-receptor antagonists (H₂RAs) or proton pump inhibitors and the associated risk of gastric cancer, which was measured using the adjusted odds ratio (OR) or the relative risk and 95%CI. An independent extraction was performed by two of the authors, and a consensus was reached.

Results: Of 4595 screened articles, 11 observational studies (n = 94558) with 5980 gastric cancer patients were included in the final analyses. When all the studies were pooled, acid suppressive drug use was associated with an increased risk of gastric cancer risk (adjusted OR = 1.42; 95%CI: 1.29-1.56, I² = 48.9%, P = 0.034). The overall risk of gastric cancer increased among H₂RA users (adjusted OR = 1.40; 95%CI: 1.24-1.59, I² = 59.5%, P = 0.008) and PPI users (adjusted OR = 1.39; 95%CI: 1.19-1.64, I² = 0.0%, P = 0.377).

Conclusion: Acid suppressive drugs are associated with an increased risk of gastric cancer. Further studies are needed to test the effect of acid suppressive drugs on gastric cancer.

Keywords: Gastric cancer; H2-receptor antagonists; Meta-analysis; Proton pump inhibitors.

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Figures

Figure 1
Figure 1
Flow diagram for identification of relevant studies.
Figure 2
Figure 2
Meta-analysis results of individual and pooled adjusted odds ratio or relative risk of gastric cancer. The size of each square is proportional to the study’s weight. Diamonds are the summary estimate from the pooled studies with 95%CI. OR: Odds ratio; RR: Relative risk.
Figure 3
Figure 3
Begg’s funnel plots and Egger’s test for identifying publication bias (P = 0.857) in a meta-analysis of observational studies (n = 11). OR: Odds ratio.
See this image and copyright information in PMC

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