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Antibiotic use and risk of colorectal cancer: a systematic review and dose-response meta-analysis.
- Source :
-
British journal of cancer [Br J Cancer] 2020 Dec; Vol. 123 (12), pp. 1825-1832. Date of Electronic Publication: 2020 Sep 24. - Publication Year :
- 2020
-
Abstract
- Background: It is understudied whether the posed association of oral antibiotics with colorectal cancer (CRC) varies between antibiotic spectrums, colorectal continuum, and if a non-linear dose-dependent relationship is present.<br />Design: Three electronic databases and a trial platform were searched for all relevant studies, from inception until February 2020, without restrictions. Random-effects meta-analyses provided pooled effect-sizes (ES) with 95% confidence intervals (CI). Dose-response analyses modelling the relationship between number of days exposed to antibiotics and CRC risk were extended to non-linear multivariable random-effects models.<br />Results: Of 6483 identified publications ten were eligible, including 4.1 million individuals and over 73,550 CRC cases. The pooled CRC risk was increased among individuals who ever-used antibiotics (ES = 1.17, 95%CI 1.05-1.30), particularly for broad-spectrum antibiotics (ES = 1.70, 95%CI 1.26-2.30), but not for narrow-spectrum antibiotic (ES = 1.11, 95% 0.93-1.32). The dose-response analysis did not provide strong evidence of any particular dose-response association, and the risk patterns were rather similar for colon and rectal cancer.<br />Discussion: The antibiotic use associated CRC risk seemingly differs between broad- and narrow-spectrum antibiotics, and possibly within the colorectal continuum. It remains unclear whether this association is causal, requiring more mechanistic studies and further clarification of drug-microbiome interactions.
- Subjects :
- Anti-Bacterial Agents administration & dosage
Colorectal Neoplasms chemically induced
Confidence Intervals
Databases as Topic
Dose-Response Relationship, Drug
Gastrointestinal Microbiome drug effects
Gastrointestinal Microbiome physiology
Humans
Risk Factors
Anti-Bacterial Agents adverse effects
Colonic Neoplasms chemically induced
Rectal Neoplasms chemically induced
Subjects
Details
- Language :
- English
- ISSN :
- 1532-1827
- Volume :
- 123
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- British journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 32968205
- Full Text :
- https://doi.org/10.1038/s41416-020-01082-2