Dose-response relationship between aspirin and gastric cancer risk: A systematic review and meta-analysis.

Gastric cancer (GC) continues to be a significant global health burden, ranking as the fifth most prevalent malignancy and the fourth leading cause of cancer-related mortality worldwide. Emerging evidence suggests that aspirin, a well-known cyclooxygenase (COX) inhibitor, may play a role in reducing the risk of gastric cancer. However, the dose-response relationship between aspirin use and gastric cancer risk remains unclear. This systematic review and meta-analysis aimed to elucidate this relationship by analyzing data from cohort studies published between January 1, 2014, and January 1, 2024. A comprehensive search of PubMed, Embase, and Web of Science yielded six eligible studies involving over 1.5 million participants. The results demonstrated a significant inverse association between aspirin dose and gastric cancer risk, with a relative risk (RR) of 0.73 (95 % CI: 0.57-0.94) for the highest versus lowest aspirin dose. Dose-response analysis revealed a nonlinear relationship, suggesting that higher doses of aspirin were associated with a greater reduction in gastric cancer risk. Subgroup analyses suggested regional variations in the protective effect of aspirin, with stronger associations observed in Asian populations. Our results provide strong evidence of the association between dose of aspirin use and risk of gastric cancer. These findings highlight the potential role of aspirin in gastric cancer chemoprevention and offer valuable insights for future research and clinical applications.