Aspirin and non-steroidal anti-inflammatory drugs use reduce gastric cancer risk: A dose-response meta-analysis
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Xuan-zhang Huang1,*, You Chen2,*, Jian Wu1, Xi Zhang1, Cong-cong Wu1, Chao-ying Zhang1, Shuang-shuang Sun1, Wen-jun Chen1
1Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City 325027, P.R. China
2The Wenzhou Dental Hospital, Wenzhou City 325027, P.R. China
*Xuan-zhang Huang and You Chen contributed equally to this work
Wen-jun Chen, email: firstname.lastname@example.org
Keywords: aspirin, non-steroidal anti-inflammatory drugs, gastric cancer, chemoprevention, meta-analysis
Received: July 25, 2016 Accepted: November 14, 2016 Published: November 25, 2016
Background: The association between non-steroidal anti-inflammatory drugs (NSAIDs) and gastric cancer (GC) risk is controversial. The aim of this study is to evaluate the chemopreventive effect of NSAIDs for GC.
Methods: A literature search was performed for relevant studies using the PubMed and Embase database (up to March 2016). Risk ratios (RRs) and 95% confidence intervals (CIs) were used as the effect measures. The dose–response analysis and subgroup analysis were also performed.
Results: Twenty-four studies were included. Our results indicated that NSAIDs could reduce GC risk (any NSAIDs: RR=0.78, 96%CI=0.72-0.85; aspirin: RR=0.70, 95%CI=0.62-0.80; non-aspirin NSAIDs: RR=0.86, 95%CI=0.80-0.94), especially for non-cardia GC risk. Moreover, the dose-response analysis indicated the risk of GC decreased by 11% and 5% for 2 years increment of any NSAIDs and aspirin use, respectively. There were nonlinear relationships between the frequency of any NSAIDs use and aspirin use and GC risk (P for non-linearity<0.01), with a threshold effect of 5 times/week. A monotonically decreasing trend was observed only for the frequency of less than 5 times/week.
Conclusions: Our results indicate that NSAIDs is inversely associated with GC risk, especially for non-cardia GC risk. NSAIDs use may become a feasible approach to prevent GC.
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