Evidence map›Paper›PMID 40344467›Full record

SynthesisClinical and translational science2025

Chemoprevention of Gastrointestinal Cancers: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials and Cohort Studies.

Jia En Chan, Suresh Shanmugham, Suresh Kumar, Yeong Yeh Lee, Siew Mooi Ching, Nathorn Chaiyakunapruk, Sajesh K Veettil

Abstract readSystematic Review
In one paragraph

Synthesis in Clinical and translational science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jia En ChanDepartment of Pharmacy Practice, School of Pharmacy, IMU University, Kuala Lumpur, Malaysia.ORCID 0009-0004-2453-1284
Suresh ShanmughamDepartment of Pharmacy Practice, School of Pharmacy, IMU University, Kuala Lumpur, Malaysia.ORCID 0000-0002-3386-7941
Suresh KumarDepartment of Pharmacy Practice, School of Pharmacy, IMU University, Kuala Lumpur, Malaysia.ORCID 0000-0002-2806-1986
Yeong Yeh LeeSchool of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.ORCID 0000-0002-6486-7717
Siew Mooi ChingFaculty of Medicine and Health Sciences, Department of Family Medicine, Universiti Putra Malaysia, Seri Kembangan, Malaysia.ORCID 0000-0002-4425-7989
Nathorn ChaiyakunaprukDepartment of Pharmacotherapy, University of Utah, Salt Lake City, Utah, USA.ORCID 0000-0003-4572-8794
Sajesh K VeettilDepartment of Pharmacy Practice, School of Pharmacy, IMU University, Kuala Lumpur, Malaysia.ORCID 0000-0002-7009-7907

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Several meta-analyses have investigated the association between chemopreventive agents (CPAs) and the risk of gastrointestinal cancers, but syntheses of the quality of evidence in aggregate are lacking. This umbrella review aimed to assess the quality of evidence from meta-analyses of randomized controlled trials (RCTs) and cohort studies that examine inverse associations between CPAs and the risk of gastrointestinal cancers or any premalignant conditions. Summary effect sizes from random-effects models, between-study heterogeneity, 95% prediction interval, small-study effect, excess significance, and credibility ceilings were devised to classify the credibility of evidence from meta-analyses of cohort studies, whereas the GRADE approach was used for meta-analyses of RCTs. From 20,296 publications, 577 full-text articles were evaluated for eligibility, and 69 articles that provided 194 unique meta-analyses were included. Among meta-analyses of RCTs (N = 93), 26 reached statistical significance (p < 0.05). Seven inverse associations were graded as either high quality (celecoxib and colorectal adenomas, (N = 4)) or moderate (aspirin and colorectal adenomas, (N = 2) and H-pylori eradication and gastric cancer (N = 1)). Among meta-analyses of cohort studies (N = 101), 60 reached statistical significance. Four inverse associations were graded as either convincing (antivirals with hepatocellular carcinoma (HCC); N = 1) or highly suggestive (aspirin with HCC (N = 2) and colorectal cancer (N = 1)). This review suggests that the associations with the most consistent empirical evidence were confined to those targeting the well-established risk factors of gastrointestinal cancer progression. Despite the limited established evidence, the inverse associations observed between metformin and colorectal, esophageal, and gastric cancers, as well as between statins and HCC and gastric cancer, merit further research.

Indexed as

ChemopreventionGastrointestinal NeoplasmsCohort StudiesHumansMeta-Analysis as TopicRandomized Controlled Trials as Topicchemopreventioncohort studiesgastrointestinal cancersmeta‐analysisrandomized controlled trialumbrella review

Identifiers

PMID40344467
PMCPMC12061847

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.