Abstract
Objective: Although several chemopreventive drugs against gastric cancer have been proposed, their effects have not been fully evaluated. We examined the impacts of aspirin, metformin, and statin use on gastric cancer development in a population-based cohort in Korea, where gastric cancer is prevalent. Design: We analyzed the association between potential chemopreventive drugs—aspirin, metformin, and statin—and gastric cancer through the Observational Medical Outcomes Partnership Common Data Model-based Korean nationwide cohort. To summarize the current evidence, we further performed a systematic review and meta-analysis of the impact of aspirin, metformin, and statin on gastric cancer development. Results: After propensity-score matching, 66,166, 15,962, and 33,408 subjects were observed for medians of 5.8, 5.3, and 5.3 years for aspirin, metformin, and statin, respectively. Use of aspirin or statin was associated with lower risks of gastric cancer compared to their non-use, respectively (hazard ratio [HR] [95% confidence interval [CI]]: aspirin, 0.84 [0.72–0.97]; statin, 0.66 [0.52–0.82]). However, no association was observed between metformin use and gastric cancer development (HR [95% CI]: 1.00 [0.74–1.34]). A subgroup of subjects with diabetes mellitus showed a lower risk of gastric cancer development with statin use. The meta-analysis showed the highest effect size on gastric cancer development for statin, followed by aspirin and metformin. Conclusion: Statin and aspirin use were associated with significantly reduced risks of gastric cancer development, while the use of metformin was not. The protective effect of statin against gastric cancer was also significant in patients with diabetes mellitus. Funding Statement: This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C0143). Declaration of Interests: None. Ethics Approval Statement: The protocol of the current study was approved by the Institutional Review Board of Kangdong Sacred Heart Hospital (IRB no. 2019-05-014).
Published Version
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