Medication use and risk of proximal colon cancer: a systematic review of prospective studies with narrative synthesis and meta-analysis.
Etiology
Medication
Meta-analysis
Proximal colon cancer
Risk factor
Systematic review
Journal
Cancer causes & control : CCC
ISSN: 1573-7225
Titre abrégé: Cancer Causes Control
Pays: Netherlands
ID NLM: 9100846
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
26
11
2020
accepted:
21
06
2021
pubmed:
6
7
2021
medline:
26
11
2021
entrez:
5
7
2021
Statut:
ppublish
Résumé
Evidence of differences in the etiology of, and poorer survival from, proximal colon compared to the distal colorectum, necessitates research into its risk factors. This systematic review summarizes the evidence on medication use and proximal colon cancer risk. MEDLINE and EMBASE were searched for prospective studies investigating nine medication groups, namely non-steroidal anti-inflammatory drugs (NSAIDs), exogenous hormones, i.e., hormone replacement therapy (HRT) or oral contraceptives (OCs), statins, proton pump inhibitors, anti-hypertensives, metformin (an antidiabetic), antidiarrheals or laxatives, and the risk of proximal colon cancer. Narrative synthesis and meta-analyses, using random effects models to estimate risk ratios (RRs) and 95% confidence intervals (CIs), were conducted. Twenty nine publications investigating NSAIDs (n = 13), exogenous hormones [HRT (n = 9) or OCs (n = 4)] statins (n = 5), anti-hypertensives (n = 1), and metformin (n = 1) were included. Summary RRs reported a protective effect of aspirin use (RR 0.80, 95% CI 0.73-0.89) but no associations between HRT (RR 0.92, 95% CI 0.83-1.02), OC (RR 1.06, 95% CI 0.98-1.14) or statin use (RR 0.94, 95% CI 0.67-1.31), and proximal colon cancer incidence compared to never/non-use. One study on metformin and one on anti-hypertensives reported no association. Sources of between-study heterogeneity included study design, period of exposure ascertainment, exposure source, and exposure comparison, but this exploration was hindered by the small numbers of studies. Despite some studies on NSAID or HRT use, evidence on the impact of a range of medications on proximal colon cancer risk is limited. This highlights the need for more research to inform chemoprevention strategies.
Identifiants
pubmed: 34224060
doi: 10.1007/s10552-021-01472-8
pii: 10.1007/s10552-021-01472-8
pmc: PMC8417019
doi:
Substances chimiques
Anti-Inflammatory Agents, Non-Steroidal
0
Aspirin
R16CO5Y76E
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1047-1061Subventions
Organisme : Cancer Research UK
ID : C24523/A25192
Pays : United Kingdom
Informations de copyright
© 2021. The Author(s).
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