Aspirin and non-steroidal anti-inflammatory drugs use reduce gastric cancer risk: A dose-response meta-analysis

// Xuan-zhang Huang 1, * , You Chen 2, * , Jian Wu 1 , Xi Zhang 1 , Cong-cong Wu 1 , Chao-ying Zhang 1 , Shuang-shuang Sun 1 , Wen-jun Chen 1 1 Department of Chemotherapy and Radiotherapy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou City 325027, P.R. China 2 The Wenzhou Dental Hospital, Wenzhou City 325027, P.R. China * Xuan-zhang Huang and You Chen contributed equally to this work Correspondence to: Wen-jun Chen, email: chenwenjun2233@126.com Keywords: aspirin, non-steroidal anti-inflammatory drugs, gastric cancer, chemoprevention, meta-analysis Received: July 25, 2016 Accepted: November 14, 2016 Published: November 25, 2016 ABSTRACT 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.