Abstract
Although there is evidence that non-steroidal anti-inflammatory drugs (NSAIDs) might be able to prevent pancreatic cancer, the findings from epidemiological studies have been inconsistent. In this paper, we conducted a meta-analysis of observational studies to examine this possibility. We searched PubMed and Embase for observational (cohort or case-control) studies examining the consumption of aspirin and other NSAIDs and the incidence of or mortality rates associated with pancreatic cancer. Twelve studies including approximately 258,000 participants in total were analysed. The administration of aspirin significantly reduced the incidence of pancreatic cancer (8 studies; odds ratio (OR) = 0.77; 95% confidence interval (CI) = 0.62 to 0.96; I2 = 74.2%) but not the mortality associated with it (2 studies; OR = 0.94; 95% CI = 0.73 to 1.22). Specifically, frequent aspirin use was associated with reduced pancreatic cancer incidence (OR = 0.57; 95% CI = 0.39 to 0.83 for high frequency; OR = 0.57; 95% CI = 0.38 to 0.84 for medium frequency). The summary ORs regarding the incidence of pancreatic cancer and either non-aspirin NSAIDs use (OR = 1.08; 95% CI = 0.90 to 1.31) or overall NSAIDs use (OR = 0.97; 95% CI = 0.86 to 1.10) were not significant. In conclusion, aspirin use might reduce the incidence of pancreatic cancer; however, this finding should be interpreted with caution because of study heterogeneity.
Highlights
IntroductionThis strategy might obscure true decreases or increases in the incidence or mortality risk of pancreatic cancer associated with aspirin/NSAIDs use
Mortality of cancer were pooled to represent the overall risk of cancer
Neither overall NSAIDs use nor non-aspirin NSAIDs use was associated with a reduced risk of pancreatic cancer
Summary
This strategy might obscure true decreases or increases in the incidence or mortality risk of pancreatic cancer associated with aspirin/NSAIDs use Another meta-analysis[30] that included 8 studies (three case-controls, four cohorts, and one RCT) did not show any association between aspirin/NSAIDs use and pancreatic cancer risk in low, intermediate, or high exposure groups. Cui et al.[31] conducted a meta-analysis that included 10 studies (four case-controls, five cohorts, and one RCT) and concluded that high-dose aspirin use reduces pancreatic cancer risk This conclusion was not supported because the odds ratio (OR) of the high-dose aspirin group was not significant (odds ratio (OR) = 0.88; 95% confidence intervals (CI) = 0 .76 to 1.01; P = 0.069)[31]. Based on recent evidence, we performed a systematic review and meta-analysis of 12 observational studies to explore the possibility that NSAIDs use reduces the incidence of pancreatic cancer in real-world settings
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