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The association between acid-suppressive agent use and the risk of cancer: a systematic review and meta-analysis

  • Pharmacoepidemiology and Prescription
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Abstract

Background

Acid-suppressive agents (ASAs) may be associated with cancer; previous studies reported that the risk of cancer with acid suppressants has differed depending on the site of cancer. Here, we conducted a systematic review and meta-analysis of the association between ASA use and the type of cancer risk.

Methods

MEDLINE, EMBASE, and Cochrane library databases were searched for publications up to the end of September 2019 for MeSH terms and text words related to cancer and ASAs. Studies on the association between ASAs and cancer risk, which included a control group and reported the relative risk of cancer, were included. The inverse-variance random effect model was used to estimate the pooled relative risk (RR) and 95% confidence interval (CI), and subgroup analysis for type of acid suppressants, drug uptake duration, and cumulative doses was performed. Heterogeneity was assessed using the I2 test and Q statistic.

Results

Thirty-nine cohort and case–control studies were included. ASA use was found to be significantly associated with a 46% higher risk of gastric cancer (RR, 1.46; 95% CI, 1.18–1.80) and a 53% higher risk of liver cancer (RR, 1.53; 95% CI, 1.31–1.78) compared with nonuse; however, there was no significant association for esophageal, colorectal, pancreatic, lung, breast, prostate, and kidney cancer; melanoma; and lymphoma.

Conclusions

ASAs were significantly associated with an increased risk of gastric and liver cancer; therefore, special attention of ASA use considering the potential risk of gastric and liver cancer is needed.

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Acknowledgments

We would like to thank Caitlin E. Kantner for proofreading the manuscript.

Funding

This work was supported by the Postdoctoral Research Program of Sungkyunkwan University (2017).

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Author notes

  1. Hyun Jin Song and Nakyung Jeon contributed equally to this work as first authors.

Authors and Affiliations

  1. Department of Pharmaceutical Policy and Outcomes Research, School of Pharmacy, Sungkyunkwan University, Suwon, South Korea

    Hyun Jin Song

  2. Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, HPNP Building Room 2320, 1225 Center Drive, Gainesville, FL, 32610, USA

    Hyun Jin Song & Patrick Squires

  3. College of Pharmacy, Chonnam National University, Gwangju, South Korea

    Nakyung Jeon

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  1. Hyun Jin Song
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  2. Nakyung Jeon
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  3. Patrick Squires
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Contributions

HJS was involved in the study concept and design, literature search, study selection, quality assessment, data extraction, data analysis, data interpretation, and manuscript writing. NJ was involved in the literature search, study selection, quality assessment, data extraction, and manuscript writing. PS was involved in the study selection, quality assessment, and manuscript writing. All authors reviewed and approved the final version.

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Correspondence to Hyun Jin Song.

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Song, H.J., Jeon, N. & Squires, P. The association between acid-suppressive agent use and the risk of cancer: a systematic review and meta-analysis. Eur J Clin Pharmacol 76, 1437–1456 (2020). https://doi.org/10.1007/s00228-020-02927-8

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  • DOI: https://doi.org/10.1007/s00228-020-02927-8

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