Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis

ABSTRACT: Background: Esophageal cancer is a cancerous tumor that develops in the esophagus. It is the 10th most common cancer and has a low survival rate. Esophageal adenocarcinoma (EAC) is increasing in incidence globally. Those with EAC are affected by Barrett's esophagus metaplasia, which...

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Main Authors: Karamali Kasiri, Associate, Catherine M.T. Sherwin, Professor, Sahar Rostamian, MD, Saeid Heidari-Soureshjani, MSc
Format: Article
Language:English
Published: Elsevier 2023-01-01
Series:Current Therapeutic Research
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0011393X23000024
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author Karamali Kasiri, Associate
Catherine M.T. Sherwin, Professor
Sahar Rostamian, MD
Saeid Heidari-Soureshjani, MSc
author_facet Karamali Kasiri, Associate
Catherine M.T. Sherwin, Professor
Sahar Rostamian, MD
Saeid Heidari-Soureshjani, MSc
author_sort Karamali Kasiri, Associate
collection DOAJ
description ABSTRACT: Background: Esophageal cancer is a cancerous tumor that develops in the esophagus. It is the 10th most common cancer and has a low survival rate. Esophageal adenocarcinoma (EAC) is increasing in incidence globally. Those with EAC are affected by Barrett's esophagus metaplasia, which is attributed to genetic predisposition and is more common in men. Studies suggest that gastric acid suppressants, like proton pump inhibitors and histamine-2 receptor antagonists, have anticancer properties and reduce EAC. However, other research has suggested that they are not cancer-protective, and the use of antisecretory drugs is a risk factor for developing EAC. Objective: This systematic review and meta-analysis investigated the properties and risk factors associated with using gastric acid suppressants in patients with EAC. Methods: This meta-analysis used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Information from selected articles, including the lead author's name, year of publication, study setting, sample size, and gender, was extracted and recorded into an Excel (Microsoft, Redmond, Washington) form. Statistical data included odds ratio, hazard ratio, and/or risk ratio, with a 95% CI associated with patients with EAC and receiving gastric acid suppressants. Data were compared with individuals not receiving treatment. Publication bias was assessed using Begg's and Egger's tests. Statistical analyzes used Stata 14.0 (Stata LLC, College Station, Texas). Results: The initial electronic literature search retrieved 3761 titles/abstracts. Extensive screening selected 20 articles for analysis. Odds ratios associated with EAC in the individuals using gastric acid suppressants were 0.77 (95% CI, 0.49–1.22; P = 0.274) and 0.67 (95% CI, 0.39–1.29; P = 0.240) for proton pump inhibitors and 1.02 (95% CI, 0.44-2.36; P = 0.967) for histamine-2 receptor antagonists. Conclusions: The results found that gastric acid suppressants do not have a protective role in EAC and are not risk factors. Future studies of confounding variables and risk factors are needed to understand what affects EAC development.
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spelling doaj.art-9d93803ba764465eb6c1888b56538ce22023-06-21T06:50:44ZengElsevierCurrent Therapeutic Research0011-393X2023-01-0198100692Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-AnalysisKaramali Kasiri, Associate0Catherine M.T. Sherwin, Professor1Sahar Rostamian, MD2Saeid Heidari-Soureshjani, MSc3Department of Pediatrics, Shahrekord University of Medical Sciences, Shahrekord, IranPediatric Clinical Pharmacology and Toxicology, Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton Children's Hospital, Dayton, OhioShahrekord University of Medical Science, Student Research Committee, Shahrekord, IranModeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran; Address correspondence to: Saeid Heidari-Soureshjani, Kashani street, Shahrekord University of Medical Sciences, Shahrekord, Iran.ABSTRACT: Background: Esophageal cancer is a cancerous tumor that develops in the esophagus. It is the 10th most common cancer and has a low survival rate. Esophageal adenocarcinoma (EAC) is increasing in incidence globally. Those with EAC are affected by Barrett's esophagus metaplasia, which is attributed to genetic predisposition and is more common in men. Studies suggest that gastric acid suppressants, like proton pump inhibitors and histamine-2 receptor antagonists, have anticancer properties and reduce EAC. However, other research has suggested that they are not cancer-protective, and the use of antisecretory drugs is a risk factor for developing EAC. Objective: This systematic review and meta-analysis investigated the properties and risk factors associated with using gastric acid suppressants in patients with EAC. Methods: This meta-analysis used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Information from selected articles, including the lead author's name, year of publication, study setting, sample size, and gender, was extracted and recorded into an Excel (Microsoft, Redmond, Washington) form. Statistical data included odds ratio, hazard ratio, and/or risk ratio, with a 95% CI associated with patients with EAC and receiving gastric acid suppressants. Data were compared with individuals not receiving treatment. Publication bias was assessed using Begg's and Egger's tests. Statistical analyzes used Stata 14.0 (Stata LLC, College Station, Texas). Results: The initial electronic literature search retrieved 3761 titles/abstracts. Extensive screening selected 20 articles for analysis. Odds ratios associated with EAC in the individuals using gastric acid suppressants were 0.77 (95% CI, 0.49–1.22; P = 0.274) and 0.67 (95% CI, 0.39–1.29; P = 0.240) for proton pump inhibitors and 1.02 (95% CI, 0.44-2.36; P = 0.967) for histamine-2 receptor antagonists. Conclusions: The results found that gastric acid suppressants do not have a protective role in EAC and are not risk factors. Future studies of confounding variables and risk factors are needed to understand what affects EAC development.http://www.sciencedirect.com/science/article/pii/S0011393X23000024esophageal adenocarcinomagastric acidhistamine-2 receptor antagonistsoncologyproton pump inhibitors
spellingShingle Karamali Kasiri, Associate
Catherine M.T. Sherwin, Professor
Sahar Rostamian, MD
Saeid Heidari-Soureshjani, MSc
Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis
Current Therapeutic Research
esophageal adenocarcinoma
gastric acid
histamine-2 receptor antagonists
oncology
proton pump inhibitors
title Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis
title_full Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis
title_fullStr Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis
title_full_unstemmed Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis
title_short Assessment of the Relationship Between Gastric-Acid Suppressants and the Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis
title_sort assessment of the relationship between gastric acid suppressants and the risk of esophageal adenocarcinoma a systematic review and meta analysis
topic esophageal adenocarcinoma
gastric acid
histamine-2 receptor antagonists
oncology
proton pump inhibitors
url http://www.sciencedirect.com/science/article/pii/S0011393X23000024
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AT saharrostamianmd assessmentoftherelationshipbetweengastricacidsuppressantsandtheriskofesophagealadenocarcinomaasystematicreviewandmetaanalysis
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