S1427 Is Acid Suppression Therapy Associated With Increased Risk of Cardia Gastric Cancer? A Meta-Analysis
Bibliographic record
Abstract
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. Conclusion: 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.Table 1.: Results of quality assessment and Results of subgroups analyses. PPIs: Proton pump inhibitors; H2RA: H2 receptor antagonists, N/A: Not applicable.Figure 1.: Forest plot showing the occurrence of gastric cancer in a) patients with Juvenile Polyposis Syndrome. b) patients with SMAD4 PV related Juvenile Polyposis syndrome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.023 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.060 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".