Cohort studyindependent cross-checkabstract checked★ key study I-CAN-102 in-depth review

Gastrointestinal cancer: alternative medicine alone linked to more deaths

Complementary and alternative medicine use: impact on survival among patients with gastrointestinal cancers.

Overview

Ekenze SO et al.. J Gastrointest Surg 2026 · PMID 42607749 · DOI 10.1016/j.gassur.2026.102552

Patients who used only alternative medicine had an 86% higher risk of death; those who combined it with standard care did not.

Does the study support the specific claim? No · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: Survival with alternative medicine in GI cancers.
How was the study done?: US registry cohort.
How many people, animals or samples were studied?: 1.5 million patients; 197 alternative-only.
What was actually found?: Alternative-only use linked to higher mortality.
How large was the observed effect?: aHR 1.86 (1.37-2.51).
What do the results mean in everyday life?: Do not replace cancer treatment with alternatives.
What are the study's limitations?: Small group; observational; overlaps with other NCDB studies.
What does it say about Elawady's specific claim?: Contradicts diet as cancer treatment; supports use only alongside treatment.
Do the results apply to Germany and Europe?: Moderate.
What can explicitly not be concluded from this study?: Whether any specific diet helps.

Authors: Ekenze SO et al.
Journal: J Gastrointest Surg
Year: 2026
Identifier: PMID 42607749 DOI 10.1016/j.gassur.2026.102552
Verification: verified – PubMed efetch 2026-10-26 + Crossref
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: Authors declare no competing interests; funding not stated in abstract

Predictors of CAM use and association of CAM with overall survival in gastrointestinal cancers

Study design: Cohort study – Retrospective registry cohort (NCDB), multivariable Cox and logistic regression
Population: Adults with gastrointestinal cancers in the NCDB
Country: USA
Period: 2010-2019
Sample size: 1,526,482 (197 CAM only; 193 CAM plus traditional; 310,251 no treatment)
Inclusion and exclusion criteria: GI cancer patients categorised by treatment received

Exposure / intervention: CAM only; CAM plus traditional therapy; no treatment
Comparator: Traditional therapy
Endpoints: Overall survival
Statistical methods: Multivariable Cox and logistic regression

Results: Compared with traditional therapy: CAM alone aHR 1.86 (95% CI 1.37-2.51); no treatment aHR 1.68 (1.66-1.70); CAM plus traditional aHR 1.00 (0.78-1.27). CAM use strongly associated with pancreatic (aOR 10.22) and liver cancer (aOR 10.09).
Absolute risks: not reported in abstract
Authors' conclusion: Higher mortality among patients who used CAM alone; CAM combined with traditional therapy was not associated with higher mortality.

aHR CIs log-symmetric (recalculated). CAM-only patients were 0.013% of the cohort, so estimates are imprecise.

Direct: alternative-only management of GI cancers is linked to higher mortality; adjunctive use alongside treatment was not.

Shows that combined use (CAM alongside full treatment) was not associated with harm in GI cancers.

Moderate (US registry).

Supports the distinction: adding complementary approaches is not shown to be harmful; replacing treatment is.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	moderate
Directness	direct
Reproducibility	partly replicated
Consistency with the overall evidence	consistent
Regional transferability	moderate
Adequacy of the interpretation (by the archive)	not applicable

Diet-specific outcomes.