P2039 - Is Acid Suppression Therapy Associated With Increased Risk of Cardia Gastric Cancer? A Meta-Analysis

Chenyu Sun, MD, MSc¹, Yue Chen, ², Mohamed R. Ismail, MBBCh¹, John Pocholo W. Tuason, MD¹, Xingyu Cheng, ², Lei Hu, ², Chandur Bhan, MD¹, Na Hyun Kim, MD¹, Apurwa Prasad, MD¹, Nikitha Manem, MD¹, Sujatha Kailas, MD¹, Zeid Karadsheh, MD^3
1AMITA Health Saint Joseph Hospital, Chicago, IL; ²School of the First Clinical Medicine, Anhui Medical University, Hefei, Anhui, China; ³AMITA Heath Saint Joseph Hospital, Chicago, IL

Introduction: Gastric cancer (GC) ranks as the 3rd most common cause of cancer-related deaths and is the 5th most common cause of cancer overall. Among GC, anatomic cardia gastric cancer (CGC) is less common and generally follows the same demographic and risk factor profile as esophageal adenocarcinoma or adenocarcinoma at the gastroesophageal junction. Acid-suppression therapy, including proton pump inhibitors (PPIs) and H2 receptor antagonists (H2RAs) have been reported to be associated with an increased risk of gastrointestinal tract cancers, but conclusions of previous studies were inconsistent. Thus, this meta-analysis was conducted.

Methods: A comprehensive literature search on PubMed, Web of Science, and CNKI were conducted to identify all relevant studies published prior to May 2021 according to the established inclusion criteria. The quality assessment was performed by the Newcastle-Ottawa Scale (NOS). The pooled odds risk (OR) and 95% confidence intervals (CI) were calculated to estimate the association between the acid-suppression therapy and CGC risk. A random-effect or fixed-effect model was used to calculate the pooled OR, based on heterogeneity significance. Subgroup analyses were conducted by acid suppressant type, study location, and sample size. Sensitivity analysis and publication bias detection were also performed. All statistical analyses were performed using RevMan software (version 5.4.1; Cochrane library) and STATA 15.1 statistical software (Stata Corp., College Station, TX), and all P values were two-tailed, the test level was 0.05.

Results: Three hundred and twenty-six articles were obtained, and 5 moderate to high-quality articles with 86,845 participants were included. No statistically significant association between acid-suppression therapy and CGC risk was found (OR 1.23, 95%CI: 0.83, 1.82, P=0.29, I²=54%). In subgroup analyses based on acid suppressant type, study location, and sample size, similar conclusions were also found as shown in the table. Sensitivity analysis by changing effect models confirmed the relative stability of the result. Funnel plot, Egger's test, and Begg's test found no publication bias of analysis.

Discussion: The current meta-analysis demonstrates no association between acid-suppression therapy and increased CGC risk. However, more original studies are still needed to further clarify this conclusion.




Disclosures:


Chenyu Sun, MD, MSc¹, Yue Chen, ², Mohamed R. Ismail, MBBCh¹, John Pocholo W. Tuason, MD¹, Xingyu Cheng, ², Lei Hu, ², Chandur Bhan, MD¹, Na Hyun Kim, MD¹, Apurwa Prasad, MD¹, Nikitha Manem, MD¹, Sujatha Kailas, MD¹, Zeid Karadsheh, MD³. P2039 - Is Acid Suppression Therapy Associated With Increased Risk of Cardia Gastric Cancer? A Meta-Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.