Exposure to Commonly Used Drugs and the Risk of Gastric Cancer: An Umbrella Review of Meta-Analyses

Abstract

Recently, attention has been paid to some medications and gastric cancer (GC) risk. This review aimed to evaluate associations between commonly used drugs and GC risk and to grade evidence from published systematic reviews and meta-analyses. This umbrella review was registered in PROSPERO (CRD42022320276). The systematic reviews and meta-analyses of observational studies were retrieved by searching Embase, PubMed, and Web of Science. The evidence strength of commonly used drugs and GC risk was categorized into four grades: weak, suggestive, highly suggestive, and strong. Of 19 associations between commonly used drugs and GC risk and its subtypes, none was supported by convincing or highly suggestive evidence. The risk of GC related to non-steroidal anti-inflammatory drugs (NSAIDs), non-aspirin NSAIDs, and acid-suppressive drugs, as well as the risk of non-cardia GC related to NSAIDs and aspirin, was supported by suggestive evidence. The results showed that a reduced GC risk was associated with two drug types (NSAIDs and non-aspirin NSAIDs), and an increased GC risk was associated with acid-suppressing drugs at the suggestive evidence level. Moreover, NSAIDs and aspirin reduced non-cardia GC risk as supported by suggestive evidence. However, the evidence supporting statins or metformin in reducing GC risk was weak, and thus future studies are required to clarify these associations.

Characteristic analysis of early gastric cancer afterHelicobacter pylorieradication: a multicenter retrospective propensity score-matched study

“…Long-term use of PPI due to GERD is a characteristic of GC patients after H. pylori eradication before propensity score matching, which suggests that we should pay attention to the long-term management of GERD, especially whether refractory GERD should prioritize other non-pharmacological treatment measures such as cardiac constriction surgery. Previous studies have shown that the use of anti-platelet drugs may reduce the risk of developing GC after H. pylori eradication, which may be related to its ability to eliminate inflammation [ 31 , 32 ]. However, we did not find a significant difference in the combined use of anti-platelet drugs in GC after H. pylori eradication and in H. pylori infection-related GC.…”