Evidence map›Paper›PMID 24221456›Full record

SynthesisGut2014

Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett's oesophagus: a systematic review and meta-analysis.

Siddharth Singh, Sushil Kumar Garg, Preet Paul Singh, Prasad G Iyer, Hashem B El-Serag

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Gut, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 111 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
111citing papers in PubMed, 11 pooled it
20.6field-weighted citation impact, top 1% of its field
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

111 citing papers in PubMed, 11 syntheses or guidelines pooled it, 299 citations in OpenAlex.

  1. Chemoprevention of Barrett's Esophagus: a Systematic Review and Comprehensive Assessment of Bias.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2025
    Pooled it
  2. Pooled it
  3. Guideline
  4. Guidelines on optimizing the use of proton pump inhibitors: PPI stewardship.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023
    Guideline
  5. AGA Clinical Practice Update on New Technology and Innovation for Surveillance and Screening in Barrett's Esophagus: Expert Review.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022
    Guideline
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Guideline
  10. Pooled it
  11. ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus.The American journal of gastroenterology · 2016
    Guideline
  12. Trial
  13. Trial
  14. Esophageal cancer: from pathogenesis to precision therapies.Signal transduction and targeted therapy · 2026
    Review
  15. Review
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article

51 more citing papers are in PubMed but not listed here.

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

5 authors at 4 institutions in 1 country.

Siddharth SinghDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Sushil Kumar GargDepartment of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Preet Paul SinghDepartment of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA.
Prasad G IyerDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Hashem B El-SeragDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.
WinnMed · USBaylor College of Medicine · USMayo Clinic · USUniversity of Minnesota · US

Funding

Tissue Analysis & Molecular Imaging CoreP30DK056338 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI Geoffrey A Preidis · 2001 to 2026
$28.3M
Research Training in GastroenterologyT32DK083266 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI Hashem B El-Serag, FASIHA KANWAL · 2010 to 2026
$2.3M
Epidemiology and Outcomes of Digestive and Liver Diseases: A Mentoring ProgramK24DK078154 · NIDDK · BAYLOR COLLEGE OF MEDICINE · PI EL-SERAG, HASHEM B · 2007 to 2016
$1.1M
NIDDK NIH HHS K24 DK078154NIDDK NIH HHS P30 DK056338NIDDK NIH HHS T32 DK083266
6 · The paper itself

Abstract

BACKGROUND AND

aimsAcid-suppressive medications, particularly proton pump inhibitors (PPIs), may decrease the risk of oesophageal adenocarcinoma (OAC) in patients with Barrett's oesophagus (BO). We performed a systematic review with meta-analysis of studies evaluating the association between acid-suppressive medications (PPIs and histamine receptor antagonists (H2RAs)) and risk of OAC or high-grade dysplasia (BO-HGD) in patients with BO.

methodsWe performed a systematic search of multiple electronic databases and conference proceedings up to June 2013 to identify studies reporting the association between use of acid-suppressive medications and risk of OAC and/or BO-HGD in patients with BO. Summary ORs with 95% CIs were estimated.

resultsWe identified seven observational studies (2813 patients with BO, 317 cases of OAC or BO-HGD, 84.4% PPI users). On meta-analysis, PPI use was associated with a 71% reduction in risk of OAC and/or BO-HGD in patients with BO (adjusted OR 0.29; 95% CI 0.12 to 0.79). There was a trend towards a dose-response relationship with PPI use for >2-3 years protective against OAC or BO-HGD (three studies; PPI use >2-3 years vs <2-3 years: OR 0.45 (95% CI 0.19 to 1.06) vs 1.09 (0.47 to 2.56)). Considerable heterogeneity was observed. Two studies reported the association between H2RA use and risk of OAC and/or BO-HGD (1352 patients with BO, 156 cases of OAC, 25.4% on H2RAs), and both studies did not show a significant effect.

conclusionsBased on meta-analysis of observational studies, the use of PPIs is associated with a decreased risk of OAC and/or BO-HGD in patients with BO. None of the studies showed an increased risk of OAC. PPI use should be considered in BO, and chemopreventive trials of PPIs in patients with BO are warranted.

Indexed as

AdenocarcinomaBarrett EsophagusEsophageal NeoplasmsHistamine H2 AntagonistsHumansObservational Studies as TopicProton Pump InhibitorsRisk AssessmentHistamine H2 AntagonistsProton Pump InhibitorsAnti-Reflux TherapyBarrett's OesophagusCancer Prevention

Identifiers

PMID24221456
PMCPMC4199831
OpenAlexW2101235315

What OpenQuestion holds

Textmetadata
LicenceTDM
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 OpenQuestion graph.