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Association between proton-pump inhibitors and the risk of gastric cancer: a systematic review with meta-analysis
| Content Provider | SAGE Publishing |
|---|---|
| Author | Segna, Daniel Brusselaers, Nele Glaus, Damian Krupka, Niklas Misselwitz, Benjamin |
| Copyright Year | 2021 |
| Abstract | Introduction:The use of proton-pump inhibitors (PPI) may be associated with an increased risk of gastric cancer (GC).Objective:To review and meta-analyse available literature investigating the association between PPI use and GC risk.Methods:Two independent reviewers systematically searched Ovid MEDLINE, EMBASE, and Cochrane Library (inception to July 2020) for case-control and cohort studies assessing the association between PPI use and GC according to a predefined protocol in PROSPERO (CRD42018102536). Reviewers independently assessed study quality, extracted data, and meta-analysed available and newly calculated odds ratios (ORs) using a random-effects model, and stratified for GC site (cardia versus non-cardia) and PPI duration (<1 year, 1–3 years, >3 years).Results:We screened 2,396 records and included five retrospective cohort and eight case-control studies comprising 1,662,881 individuals in our meta-analysis. In random-effect models, we found an increased GC risk in PPI users [OR: 1.94, 95% confidence interval (95% CI): 1.47–2.56] with high statistical heterogeneity (I2 = 82%) and overall moderate risk of bias. Stratified analyses indicated a significant risk increase in non-cardia (OR: 2.20, 95% CI: 1.44–3.36, I2 = 77%) with a similar non-significant trend in cardia regions (OR: 1.77, 95% CI: 0.72–4.36, I2 = 66%). There was no GC increase with longer durations of PPI exposure (<1 year: OR: 2.29, 95% CI: 2.13–2.47, I2 = 0%; 1–3 years: OR: 1.46, 95% CI: 0.53–4.01, I2 = 35%; >3 years: OR: 2.08, 95% CI: 0.56–7.77, I2 = 61%).Conclusion:We found a twofold increased GC risk among PPI users, but this association does not confirm causation and studies are highly heterogeneous. PPI should only be prescribed when strictly indicated. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/17562848211051463?download=true |
| ISSN | 17562848 |
| Volume Number | 14 |
| Journal | Therapeutic Advances in Gastroenterology (TAG) |
| e-ISSN | 17562848 |
| DOI | 10.1177/17562848211051463 |
| Language | English |
| Publisher | Sage Publications UK |
| Publisher Date | 2021-11-10 |
| Publisher Place | London |
| Access Restriction | Open |
| Rights Holder | © The Author(s), 2021 |
| Subject Keyword | meta-analysis systematic review stomach neoplasms proton-pump inhibitors |
| Content Type | Text |
| Resource Type | Article |
| Subject | Gastroenterology |
