Association between antibiotic consumption and colon and rectal cancer development in older individuals: A territory-wide study.

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.

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.

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.

CONCLUSIONS:

Antibiotics had divergent effects on CRC development in older subjects, which varied according to the location of cancer, antibiotic class, and administration route.

• Authors: Ka Shing Cheung, Esther W Chan, Anthony Tam, Irene O L Wong, Wai Kay Seto, Ivan F N Hung, Ian C K Wong, Wai K Leung
• Journal: Cancer medicine (Cancer Med) Vol. 11 Issue 20 Pg. 3863-3872 (10 2022) ISSN: 2045-7634 [Electronic] United States
• PMID: 35488387 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Anti-Bacterial Agents
• Cyclooxygenase 2 Inhibitors
• Aspirin
• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Humans
• Middle Aged
• Aged
• Retrospective Studies
• Colorectal Neoplasms (diagnosis, epidemiology)
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Anti-Bacterial Agents (therapeutic use)
• Cyclooxygenase 2 Inhibitors
• Risk Factors
• Colonoscopy
• Rectal Neoplasms (epidemiology)
• Aspirin
• Anti-Inflammatory Agents, Non-Steroidal
• Early Detection of Cancer