Aspirin use and the risk of gastric cancer: a meta-analysis.

ABSTRACT

PURPOSE: Studies investigating the association between aspirin use and gastric cancer risk have reported conflicting results. The objective of this study was to quantitatively summarize the evidence for such a relationship. RESULTS: Two investigators independently searched the Medline, PubMed, Embase, and Academic Search Premier (EBSCO) databases. Fourteen studies with a total number of 5,640 gastric cancer cases were identified. Most of the study populations were Caucasian. The combined results based on all studies showed there was no statistically significant difference between aspirin use and gastric cancer risk (odds ratio (OR) = 0.80, 95% confidence intervals (CI) = 0.54-1.19). When stratifying by study designs and gender, results were similar except for cohort and randomized controlled trial (RCT) studies (OR = 0.72, 95% CI = 0.62-0.84). When stratifying by location and Helicobacter pylori (H. pylori) infection, we observed there were lower risks in noncardia gastric cancer (OR = 0.62, 95% CI = 0.55-0.69) and H. pylori-infected individuals (OR = 0.62, 95% CI = 0.42-0.90) for aspirin users. Among Caucasians, there were lower risks for noncardia gastric cancer (OR = 0.73, 95% CI = 0.62-0.87) and H. pylori-infected individuals (OR = 0.62, 95% CI = 0.42-0.90) also. CONCLUSIONS: This meta-analysis indicated that regular use of aspirin may be associated with reduced risk of noncardia gastric cancer, especially among Caucasians; for H. pylori-infected subjects the result was similar.