Cumulative Dose Threshold for the Chemopreventive Effect of Aspirin Against Gastric Cancer

Kim, Min-hyung; Chang, Jooyoung; Kim, Warrick Junsuk; Banerjee, Samprit; Park, Sang Min

doi:10.14309/00000434-201806000-00015

Cited by 21 publications

(25 citation statements)

References 34 publications

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“…Previous studies, including a randomized controlled trial (RCT) and our propensity scores‐matched analysis, did not find a significant association between aspirin use and gastric cancer development . The effect of aspirin use on gastric carcinogenesis remains undetermined.…”

Section: Introductionmentioning

confidence: 55%

“…A total of 33 studies were included in the final analysis (Fig. ) . Characteristics of the included studies, outcomes, characteristics of the drug exposure, and study quality are provided in Table .…”

Section: Resultsmentioning

confidence: 99%

“…1). 12,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] Characteristics of the included studies, outcomes, characteristics of the drug exposure, and study quality are provided in Table 1. A total of 1 927 971 patients were analyzed.…”

Section: Resultsmentioning

confidence: 99%

“…5 Previous meta-analyses have reported a potential relationship between aspirin use and prevention of gastric cancer. [6][7][8][9][10][11][12][13][14] Previous studies, including a randomized controlled trial (RCT) and our propensity scores-matched analysis, [15][16][17][18][19][20][21][22][23][24][25][26][27][28] did not find a significant association between aspirin use and gastric cancer development. 29 The effect of aspirin use on gastric carcinogenesis remains undetermined.…”

Section: Introductionmentioning

confidence: 99%

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Effect of aspirin use on gastric cancer incidence and survival: A systematic review and meta‐analysis

et al. 2019

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Background and Aim A number of recent studies have been published evaluating the chemopreventive effect of aspirin against gastric cancer, and an updated meta‐analysis is required to evaluate this relationship further. This study presents a meta‐analysis of studies examining the effect of aspirin on gastric cancer incidence and death. Methods The PUBMED and Cochrane Central Registration of Controlled Trials databases were searched for eligible studies published up to December 2018. Pooled risk ratios for gastric cancer incidence and death in aspirin users versus nonusers were determined using fixed‐ and random‐effects models. The influence of the frequency of aspirin use, duration of aspirin use, and geographic location on gastric cancer incidence was evaluated. Results The meta‐analysis comprised 33 studies with a total of 1 927 971 patients. The pooled risk ratios for gastric cancer incidence in the fixed‐ and random‐effects models were 0.890 (95% confidence interval, 0.871–0.909) and 0.826 (0.740–0.922), respectively. In Asia and North America, the maximum preventive benefit of aspirin use was observed with weekly or daily use. Aspirin use was most effective for noncardiac gastric cancer. The pooled risk ratios for gastric cancer death in the fixed‐ and random‐effects models were 0.798 (0.749–0.850) and 0.894 (0.780–1.024), respectively. Significant heterogeneity was observed among studies of gastric cancer incidence but not gastric cancer death. Conclusion Aspirin use may reduce the risk of gastric cancer incidence and death; however, the relationship may be limited to a specific frequency and duration of aspirin use and geographic location.

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Section: Introductionmentioning

confidence: 55%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of aspirin use on gastric cancer incidence and survival: A systematic review and meta‐analysis

et al. 2019

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“…The institutional review board of Seoul National University Hospital (Seoul, South Korea) approved the protocol (IRB number: E-1509-004-699). Detailed methodology information was reported previously (8).…”

Section: Methodsmentioning

confidence: 99%

Aspirin Does Not Prevent Pancreatic Cancer in a Large Asian Cohort

Kim

Park

Yun

et al. 2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Evidence has suggested that aspirin reduces the incidence of several cancers, but these benefits may not occur with pancreatic cancer.Methods: A 12-year nationwide longitudinal cohort merged with the health checkup data was divided into "exposure ascertainment period" and "outcome ascertainment period" to avoid immortal time bias. The daily defined dose system was used to indicate the drug exposure. Results:We found no significant association between aspirin use and incident pancreatic cancer based on HR.Conclusions: Aspirin does not prevent pancreatic cancer. Impact: A large Asian cohort study with reliable medication information affirms no impact of aspirin on pancreatic cancer development.

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Aspirin, metformin, and statin use on the risk of gastric cancer: A nationwide population‐based cohort study in Korea with systematic review and meta‐analysis

et al. 2021

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Background/Aims Although several chemopreventive drugs against gastric cancer have been proposed, their effects have not been fully evaluated. We examined the impacts of aspirin, metformin, and statin use on gastric cancer development in a population‐based cohort in Korea. Methods We analyzed the association between potential chemopreventive drugs—aspirin, metformin, and statin—and gastric cancer through the Observational Medical Outcomes Partnership Common Data Model‐based Korean nationwide cohort. Use of aspirin, metformin, and statin was defined by ≥365 days of prescriptions for each drug in the general population. To summarize the current evidence, we further performed a systematic review and meta‐analysis of the impact of aspirin, metformin, and statin on gastric cancer development. Results After propensity score matching, 31,839, 6764, and 10,251 subjects were observed for medians of 4.7, 4.2, and 4.2 years for aspirin, metformin, and statin analysis, respectively. Use of aspirin or statin was associated with lower risks of gastric cancer compared to their non‐use, respectively (hazard ratio [HR] [95% confidence interval [CI]]: aspirin, 0.72 [0.60–0.85], p < 0.01; statin, 0.67 [0.49–0.92], p = 0.01). However, no association was observed between metformin use and gastric cancer development (HR [95% CI]: 0.85 [0.59–1.23], p = 0.40). A subgroup of subjects with diabetes mellitus showed a lower risk of gastric cancer development with statin use. The meta‐analysis showed the highest effect size of gastric cancer development for statin, followed by aspirin and metformin. Conclusions Statin and aspirin use were associated with significantly reduced risks of gastric cancer development, while the use of metformin was not associated with the gastric cancer risk. The protective effect of statin against gastric cancer was also significant in patients with diabetes mellitus.

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Cumulative Dose Threshold for the Chemopreventive Effect of Aspirin Against Gastric Cancer

Cited by 21 publications

References 34 publications

Effect of aspirin use on gastric cancer incidence and survival: A systematic review and meta‐analysis

Effect of aspirin use on gastric cancer incidence and survival: A systematic review and meta‐analysis

Aspirin Does Not Prevent Pancreatic Cancer in a Large Asian Cohort

Aspirin, metformin, and statin use on the risk of gastric cancer: A nationwide population‐based cohort study in Korea with systematic review and meta‐analysis

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