+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Proton Pump Inhibitors Do Not Reduce the Risk of Esophageal Adenocarcinoma in Patients with Barrett's Esophagus: A Systematic Review and Meta-Analysis



Proton Pump Inhibitors Do Not Reduce the Risk of Esophageal Adenocarcinoma in Patients with Barrett's Esophagus: A Systematic Review and Meta-Analysis



Plos one 12(1): E0169691



Proton pump inhibitors (PPIs) have been used for treatment of Barrett's esophagus (BE) for many years. However, the connection between PPIs and esophageal adenocarcinoma (EAC) in patients with BE has still been controversial. The current systematic review and meta-analysis was designed to evaluate the association between PPIs and the risk of EAC or high-grade dysplasia (HGD) in patients with BE. A systematic literature search of studies reporting the association between PPIs and the risk of EAC and/or HGD in patients with BE was conducted in PubMed, Embase, Web of Science and the Cochrane Library. Next, literature was screened using previously established criteria and relevant data were extracted from included studies. Finally, the software program Review Manage 5.2 was applied to aggregate data and analyze the results. Nine observational studies, comprising five cohort and four case-control studies (including a total of 5712 patients with BE), were identified. Upon meta-analysis, PPIs were found to have no association with the risk of EAC and/or HGD in patients with BE (unadjusted OR 0.43, 95% CI 0.17-1.08). Analysis for duration response relationship revealed no significant trend toward protection against EAC or HGD with PPIs usage for >2~3 years (one study using 7-year cutoff) when compared to usage for shorter time periods (PPIs usage >2~3 years vs. <2~3 years: OR 0.91 (95% CI 0.25-3.31) vs. 0.91 (0.40-2.07)).There also was considerable heterogeneity between studies. No dysplasia- or cancer-protective effects of PPIs usage in patients with BE were identified by our analysis. Therefore, we conclude that clinicians who discuss the potential chemopreventive effects of PPIs with their patients, should be aware that such an effect, if exists, has not been proven with statistical significance.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 060148681

Download citation: RISBibTeXText

PMID: 28072858


Related references

Risk of esophageal adenocarcinoma and mortality in patients with Barrett's esophagus: a systematic review and meta-analysis. Clinical Gastroenterology and Hepatology 8(3): 235-44; Quiz E32, 2010

Exam 1: Risk of Esophageal Adenocarcinoma and Mortality in Patients With Barrett's Esophagus: A Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology 8(3): E31-E32, 2010

T1927 Risk of Esophageal Adenocarcinoma and Mortality in Patients with Barrett Esophagus: A Systematic Review and Meta-Analysis. Gastroenterology 136(5): A-602, 2009

Medications (NSAIDs, statins, proton pump inhibitors) and the risk of esophageal adenocarcinoma in patients with Barrett's esophagus. Gastroenterology 138(7): 2260-2266, 2010

Medications (Nsaids, Statins, Proton Pump Inhibitors) and the Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus. Yearbook of Gastroenterology 2010: 5-6, 2010

Phase I and II enzyme polymorphisms as risk factors for Barrett's esophagus and esophageal adenocarcinoma: a systematic review and meta-analysis. Diseases of the Esophagus 22(7): 571-587, 2009

Proton pump inhibitors reduce the risk of neoplastic progression in patients with Barrett's esophagus. Clinical Gastroenterology and Hepatology 11(4): 382-388, 2013

Does the treatment of proton pump inhibitors reduce dysplasia or adenocarcinoma development in Barrett's esophagus?. Turkish Journal of Gastroenterology 28(Suppl 1): S31-S32, 2017

Statins are associated with reduced risk of esophageal cancer, particularly in patients with Barrett's esophagus: a systematic review and meta-analysis. Clinical Gastroenterology and Hepatology 11(6): 620-629, 2013

Tu1110 - Prevalence of Barrett's Esophagus in Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis. Gastroenterology 154(6): S-894, 2018

Magnitude of Missed Esophageal Adenocarcinoma After Barrett's Esophagus Diagnosis: A Systematic Review and Meta-analysis. Gastroenterology 150(3): 599-607.E7; Quiz E14-5, 2016

Incidence of esophageal adenocarcinoma in Barrett's esophagus with low-grade dysplasia: a systematic review and meta-analysis. Gastrointestinal Endoscopy 79(6): 897-909.E4; Quiz 983.E1 983.E3, 2014

Impact of Surveillance in Barrett's Esophagus on Esophageal Adenocarcinoma Outcomes: A Systematic Review and Meta-Analysis. Gastroenterology 152(5): S451-S452, 2017

Sa1837 Does Use of Nsaids, Statins and Proton Pump Inhibitors Prevent Development of Esophageal Adenocarcinoma Among Patients With Barrett's Esophagus? -Results From a Multinational Population Based Case-Control Study. Gastroenterology 146(5): S-308, 2014

Proton Pump Inhibitor Use but Not Statin Use Is Associated With Decreased Risk for High-grade Dysplasia and Esophageal Adenocarcinoma in Patients With Barrett's Esophagus: Results From a Large, Multicenter Cohort Study. Gastroenterology 146(5): S-123, 2014