© 2003 by Oxford University Press
© 2003 Oxford University Press
ARTICLE |
Non-steroidal Anti-inflammatory Drug Use and the Risk of Gastric Cancer: A Systematic Review and Meta-analysis
Affiliations of authors: Department of Gastroenterology, First Hospital, Peking University, Beijing, China (WHW); Department of Medicine (JQH, GFZ, SKL, BCYW), Clinical Trials Centre (JQH, JK), Faculty of Medicine, University of Hong Kong, Hong Kong.
Correspondence to: Benjamin C.-Y. Wong, MD, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong (e-mail: bcywong{at}hku.hk)
Background: The relationship between the use of non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, and the risk of gastric cancer has not been well studied. We performed a systematic review and meta-analysis of published studies to evaluate the association between use of this class of drugs and the risk of gastric cancer. Methods: A fully recursive literature search to January 2003 was conducted in MEDLINE, PubMed, and CANCERLIT to identify potentially relevant case-control or cohort studies. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated under a random-effects model. Results: Nine studies (eight case-control and one cohort) with a total of 2831 gastric cancer case patients were identified. NSAID use was associated with a reduced risk of gastric cancer, with a summary odds ratio of 0.78 (95% CI = 0.69 to 0.87). Users of aspirin (OR = 0.73, 95% CI = 0.63 to 0.86) and non-aspirin NSAIDs (OR = 0.74, 95% CI = 0.55 to 1.00) experienced similar magnitudes of risk reduction. Regular users of NSAIDs (OR = 0.57, 95% CI = 0.44 to 0.74) experienced a lower risk of gastric cancer relative to nonusers than did irregular users (OR = 0.76, 95% CI = 0.62 to 0.94; P = .09 versus regular users). A stratified analysis showed that NSAID use was associated with a statistically significant reduction in risk of noncardia gastric cancer (OR = 0.72, 95% CI = 0.58 to 0.89), but not of gastric cancer at the cardia (OR = 0.80, 95% CI = 0.53 to 1.20). There was no evidence that study design or type of control subject substantially influenced the estimate of effects. Conclusion: NSAID use was associated with a decreased risk of gastric cancer in a dose-dependent manner. This finding warrants proper clinical trials in populations with high risk of gastric cancer.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  U. Kiltz, J. Zochling, W. E. Schmidt, and J. Braun Use of NSAIDs and infection with Helicobacter pylori--what does the rheumatologist need to know? Rheumatology, May 13, 2008; (2008) ken123v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Duan, A. H. Wu, J. Sullivan-Halley, and L. Bernstein Nonsteroidal Anti-inflammatory Drugs and Risk of Esophageal and Gastric Adenocarcinomas in Los Angeles County Cancer Epidemiol. Biomarkers Prev., January 1, 2008; 17(1): 126 - 134. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kuriki, K. Wakai, K. Matsuo, A. Hiraki, T. Suzuki, Y. Yamamura, K. Yamao, T. Nakamura, M. Tatematsu, and K. Tajima Gastric Cancer Risk and Erythrocyte Composition of Docosahexaenoic Acid with Anti-inflammatory Effects Cancer Epidemiol. Biomarkers Prev., November 1, 2007; 16(11): 2406 - 2415. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Dube, A. Rostom, G. Lewin, A. Tsertsvadze, N. Barrowman, C. Code, M. Sampson, and D. Moher The Use of Aspirin for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force Ann Intern Med, March 6, 2007; 146(5): 365 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Namba, T. Hoshino, K.-i. Tanaka, S. Tsutsumi, T. Ishihara, S. Mima, K. Suzuki, S. Ogawa, and T. Mizushima Up-Regulation of 150-kDa Oxygen-Regulated Protein by Celecoxib in Human Gastric Carcinoma Cells Mol. Pharmacol., March 1, 2007; 71(3): 860 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Larsson, E. Giovannucci, L. Bergkvist, and A. Wolk Aspirin and Nonsteroidal Anti-inflammatory Drug Use and Risk of Pancreatic Cancer: A Meta-analysis Cancer Epidemiol. Biomarkers Prev., December 1, 2006; 15(12): 2561 - 2564. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. K. Leung, E. K.W. Ng, F. K.L. Chan, W. Y. Chan, K.-f. Chan, A. C.M. Auyeung, C. C.H. Lam, J. Y.W. Lau, and J. J.Y. Sung Effects of Long-term Rofecoxib on Gastric Intestinal Metaplasia: Results of a Randomized Controlled Trial Clin. Cancer Res., August 1, 2006; 12(15): 4766 - 4772. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Hayden, P. Cote, and C. Bombardier Evaluation of the quality of prognosis studies in systematic reviews. Ann Intern Med, March 21, 2006; 144(6): 427 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y.-J. Chang, M.-S. Wu, J.-T. Lin, and C.-C. Chen Helicobacter pylori-Induced Invasion and Angiogenesis of Gastric Cells Is Mediated by Cyclooxygenase-2 Induction through TLR2/TLR9 and Promoter Regulation J. Immunol., December 15, 2005; 175(12): 8242 - 8252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-S. Wu, C.-J. Chen, and J.-T. Lin Host-Environment Interactions: Their Impact on Progression from Gastric Inflammation to Carcinogenesis and on Development of New Approaches to Prevent and Treat Gastric Cancer Cancer Epidemiol. Biomarkers Prev., August 1, 2005; 14(8): 1878 - 1882. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Abstracts Gut, April 1, 2005; 54(suppl_2): a1 - a117. [Full Text] [PDF]
|
|
|
|
|
|
C. M. Ulrich, J. Whitton, J.-H. Yu, J. Sibert, R. Sparks, J. D. Potter, and J. Bigler PTGS2 (COX-2) -765G > C Promoter Variant Reduces Risk of Colorectal Adenoma among Nonusers of Nonsteroidal Anti-inflammatory Drugs Cancer Epidemiol. Biomarkers Prev., March 1, 2005; 14(3): 616 - 619. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Q. Gu, J. D. Wang, H. H.X. Xia, M. C.M. Lin, H. He, B. Zou, S. P. Tu, Y. Yang, X. G. Liu, S. K. Lam, et al. Activation of the caspase-8/Bid and Bax pathways in aspirin-induced apoptosis in gastric cancer Carcinogenesis, March 1, 2005; 26(3): 541 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
JournalScan Gut, April 1, 2004; 53(4): 613 - 613. [Full Text] [PDF]
|
|