Peptic Ulcer Disease and its Treatments and Risk of Pancreatic Cancer: a Meta-analysis.

Background and objective: Pancreatic cancer (PC) is the seventh leading cause of death among cancers mortality. Pancreatic carcinogenesis remains poorly understood. There is still an urge to allocate other related risk factors that may help in better recognition of this pathogenesis. There is increasing evidence suggested that peptic ulcer disease (PUD), and its treatment might affect the development of PC however, studies findings reported conflicting results. Our meta-analysis aimed to study the association between PUD and its treatments (proton pump inhibitors [PPIs] and histamine-2 receptor antagonists [H2RAs]) and risk of PC.

Methods: We searched PubMed/MEDLINE, Embase, and Cochrane library databases from inception through January 2022. We included case-control studies, cohort, and randomized control trials which reported the association between PUD, PPIs, and H2RAs and the risk of PC. Odds ratio (OR) were used to calculate pooled estimates for PC risk. The association were evaluated using random-effects models, in two sided statistical tests.

Results: A total of 22 publications were retained for the meta-analysis. PUD was associated with a significant increase in PC risk (OR 1.26, 95% CI= 1.01-1.57, P= 0.038, I2= 92%). The risk of developing PC were significant in patients receiving PPIs (OR 1.76, 95% CI= 1.26-2.46, P=0.001, I2= 98%) and H2RAs (OR 1.25, 95% CI = 1.042- 1.49, P= 0.016, I2= 80%).

Conclusions: There is a 1.26-fold increase risk of PC in patients with PUD. The elevated PC is also attributable to 1.76-fold greater risk in PPIs group compared to 1.25-fold in H2RAs group.