J Cancer 2016; 7(15):2247-2257. doi:10.7150/jca.16524

Research Paper

The Effects of Anti-inflammatory Drug Treatment in Gastric Cancer Prevention: an Update of a Meta-analysis

Pengfei Kong1, 2*, Ruiyan Wu1*, Xuechao Liu1, 3*, Jianjun Liu1, 3*, Shangxiang Chen1, 3, Minting Ye1, 2, Chenlu Yang1, 4, Ze Song1, 5, Wenzhuo He1, 2, Chenxi Yin1, 6, Qiong Yang1, 2, Chang Jiang1, 2, Fangxin Liao1, 4, Roujun Peng1, 2, Zhiwei Zhou1, 3, Dazhi Xu1, 3, Liangping Xia1, 2✉

1. State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, 510000, PR China;
2. Department of the VIP region, Sun Yat-sen University Cancer Centre, Guangzhou, 510000, PR China;
3. Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Centre, Guangzhou, 510000, PR China;
4. Department of the Gynaecologic Oncology Surgery, Sun Yat-sen University Cancer Centre, Guangzhou, 510000, PR China;
5. Department of the Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Centre, Guangzhou, 510000, PR China;
6. Department of the ICU, Sun Yat-sen University Cancer Centre, Guangzhou, 510000, PR China.
* Equal contributors.

Abstract

Gastric cancer has high incidence and fatality rates, making chemoprevention agents necessary. There is an ongoing debate about aspirin/nonsteroidal anti-inflammatory drugs (NSAIDs) use can significant reduce the risk of GC. We conducted a meta-analysis of existing studies evaluating the association of anti-inflammatory drug and GC. We performed a systematic literature search of PubMed, Web of Science, Embase, OVID, Cochrane Library and Clincialtrials.gov up to August 31, 2015. Either a fixed-effects or a random-effects model using was based on the result of homogeneity analysis. Subgroup, sensitivity, meta-regression, and publication bias analyses were evaluated. Forty-seven studies were finally included in this meta-analysis. The overall GC risk reduction benefit associated with anti-inflammatory drug use represented an RR of 0.78 (95% CI 0.71 to 0.85) and an adjusted RR of 0.74 (95% CI 0.71 to 0.77). Besides, the prevention benefit of aspirin/NSAIDs ingestion appeared to be confined to those patients with regiment of short or middle-term (≤5 years), high-frequency (>30 times per month) and low dose (<200 mg per day). Further, our data also suggest that COX-2 inhibitors use is a more effective approach in GC prevention (RR, 0.45; 95% CI, 0.29-0.70). In this meta-analysis, our finding support short or middle-term (≤5 years), high-frequency (>30 times per month) and low dose (<200 mg per day) aspirin/NSAIDs intake is a well method for GC prevention and also confirm the inverse association between aspirin/NSAIDs use and GC risk. Additionally, selective COX-2 inhibitors use probably a more effective approach to reduce GC risk.

Keywords: anti-inflammatory drug, gastric cancer, risk factor, prevention, meta-analysis.

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How to cite this article:
Kong P, Wu R, Liu X, Liu J, Chen S, Ye M, Yang C, Song Z, He W, Yin C, Yang Q, Jiang C, Liao F, Peng R, Zhou Z, Xu D, Xia L. The Effects of Anti-inflammatory Drug Treatment in Gastric Cancer Prevention: an Update of a Meta-analysis. J Cancer 2016; 7(15):2247-2257. doi:10.7150/jca.16524. Available from http://www.jcancer.org/v07p2247.htm