Meta-Analysis
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World J Gastroenterol. Apr 28, 2013; 19(16): 2560-2568
Published online Apr 28, 2013. doi: 10.3748/wjg.v19.i16.2560
Acid suppressive drugs and gastric cancer: A meta-analysis of observational studies
Jeong Soo Ahn, Chun-Sick Eom, Christie Y Jeon, Sang Min Park
Jeong Soo Ahn, Sang Min Park, Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, South Korea
Chun-Sick Eom, Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 200-702, South Korea
Christie Y Jeon, Center for Cancer Prevention and Control Research, UCLA Fielding School of Public Health, Los Angeles, CA 90095, United States
Author contributions: Ahn JS and Park SM had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis; Ahn JS and Park SM designed the study; Ahn JS, Park SM and Eom CS performed the data acquisition; Ahn JS and Jeon CY analyzed the data; Ahn JS, Park SM and Jeon CY wrote the paper; all the authors have approved the final submitted manuscript.
Supported by A National Research Foundation of Korea Grant funded by the Korean Government, No. 2010-0004429
Correspondence to: Dr. Sang Min Park, Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea. sangmin.park.snuh@gmail.com
Telephone: +82-2-20723331 Fax: +82-2-7663276
Received: August 17, 2012
Revised: March 4, 2013
Accepted: March 8, 2013
Published online: April 28, 2013
Processing time: 257 Days and 12.3 Hours
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: H2-receptor antagonists; Proton pump inhibitors; Gastric cancer; Meta-analysis