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Association between antibiotic consumption and colon and rectal cancer development in older individuals: A territory-wide study.
- Source :
-
Cancer medicine [Cancer Med] 2022 Oct; Vol. 11 (20), pp. 3863-3872. Date of Electronic Publication: 2022 Apr 29. - Publication Year :
- 2022
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Abstract
- Background: Antibiotics may alter colorectal cancer (CRC) risk due to gut dysbiosis. We aimed to study the specific and temporal effects of various antibiotics on CRC development in older individuals.<br />Methods: This was a territory-wide retrospective cohort study. Subjects aged 60 years and older who did not have CRC diagnosed on screening/diagnostic colonoscopy diagnosed between 2005 and 2013 were recruited. Exclusion criteria were history of CRC, colectomy, inflammatory bowel disease, and CRC diagnosed within 6 months of index colonoscopy. Exposure was use of any antibiotics up to 5 years before colonoscopy. The primary outcomes were CRC diagnosed >6 m after colonoscopy. Covariates were patient demographics, history of colonic polyps/polypectomy, concomitant medication use (NSAIDs, COX-2 inhibitors, aspirin, and statins), and performance of endoscopy centers (colonoscopy volume and polypectomy rate). Stratified analysis was conducted according to nature of antibiotics and location of cancer.<br />Results: Ninety seven thousand one hundred and sixty-two eligible subjects (with 1026 [1.0%] cases of CRC) were identified, 58,704 (60.4%) of whom were exposed to antibiotics before index colonoscopy. Use of antibiotics was associated with a lower risk of cancer in rectum (adjusted hazard ratio [aHR]: 0.64, 95% CI: 0.54-0.76), but a higher risk of cancer in proximal colon (aHR: 1.63, 95%CI: 1.15-2.32). These effects differed as regards the anti-anaerobic/anti-aerobic activity, narrow-/broad-spectrum, and administration route of antibiotics.<br />Conclusions: Antibiotics had divergent effects on CRC development in older subjects, which varied according to the location of cancer, antibiotic class, and administration route.<br /> (© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Humans
Middle Aged
Aged
Retrospective Studies
Anti-Bacterial Agents therapeutic use
Cyclooxygenase 2 Inhibitors
Risk Factors
Colonoscopy
Aspirin
Anti-Inflammatory Agents, Non-Steroidal
Early Detection of Cancer
Colorectal Neoplasms diagnosis
Colorectal Neoplasms epidemiology
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Rectal Neoplasms epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 11
- Issue :
- 20
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 35488387
- Full Text :
- https://doi.org/10.1002/cam4.4759