Impact of antibiotic exposure on the risk of colorectal cancer
Purpose Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk. Methods We conducted a ne...
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| Published in | Pharmacoepidemiology and drug safety Vol. 24; no. 5; pp. 534 - 542 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Blackwell Publishing Ltd
01.05.2015
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1053-8569 1099-1557 1099-1557 |
| DOI | 10.1002/pds.3765 |
Cover
| Abstract | Purpose
Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk.
Methods
We conducted a nested case–control study using a large population‐based database from the UK. Cases were defined as those with any medical code of CRC. Subjects with known familial CRC syndromes or IBD were excluded from the study. For every case, four eligible controls matched on age, sex, practice site, and duration of follow‐up before index date were selected using incidence‐density sampling. Exposure of interest was antibiotic therapy before index date. Adjusted ORs and 95%CIs were estimated using conditional logistic regression analysis.
Results
A total of 20 990 cases and 82 054 controls were identified. The adjusted OR for CRC among subjects first exposed to penicillins >10 years prior to index date was 1.11 (95%CI 1.02–1.20). The risk increased significantly with the number of penicillin exposures up to 1.20 (95%CI 1.11–1.31) for >10 courses. The risk also increased with the average number of penicillin treatments per‐year (exposure intensity) with an OR of 1.04 (95%CI 1.01–1.08) per one additional treatment per year. Exposure to anti‐viral or anti‐fungal therapy was not associated with CRC risk.
Conclusions
Past exposure to multiple courses of penicillins is related to a modest elevation in CRC risk. Copyright © 2015 John Wiley & Sons, Ltd. |
|---|---|
| AbstractList | Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk.
We conducted a nested case-control study using a large population-based database from the UK. Cases were defined as those with any medical code of CRC. Subjects with known familial CRC syndromes or IBD were excluded from the study. For every case, four eligible controls matched on age, sex, practice site, and duration of follow-up before index date were selected using incidence-density sampling. Exposure of interest was antibiotic therapy before index date. Adjusted ORs and 95%CIs were estimated using conditional logistic regression analysis.
A total of 20,990 cases and 82,054 controls were identified. The adjusted OR for CRC among subjects first exposed to penicillins >10 years prior to index date was 1.11 (95%CI 1.02-1.20). The risk increased significantly with the number of penicillin exposures up to 1.20 (95%CI 1.11-1.31) for >10 courses. The risk also increased with the average number of penicillin treatments per-year (exposure intensity) with an OR of 1.04 (95%CI 1.01-1.08) per one additional treatment per year. Exposure to anti-viral or anti-fungal therapy was not associated with CRC risk.
Past exposure to multiple courses of penicillins is related to a modest elevation in CRC risk. Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk.PURPOSEGut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk.We conducted a nested case-control study using a large population-based database from the UK. Cases were defined as those with any medical code of CRC. Subjects with known familial CRC syndromes or IBD were excluded from the study. For every case, four eligible controls matched on age, sex, practice site, and duration of follow-up before index date were selected using incidence-density sampling. Exposure of interest was antibiotic therapy before index date. Adjusted ORs and 95%CIs were estimated using conditional logistic regression analysis.METHODSWe conducted a nested case-control study using a large population-based database from the UK. Cases were defined as those with any medical code of CRC. Subjects with known familial CRC syndromes or IBD were excluded from the study. For every case, four eligible controls matched on age, sex, practice site, and duration of follow-up before index date were selected using incidence-density sampling. Exposure of interest was antibiotic therapy before index date. Adjusted ORs and 95%CIs were estimated using conditional logistic regression analysis.A total of 20,990 cases and 82,054 controls were identified. The adjusted OR for CRC among subjects first exposed to penicillins >10 years prior to index date was 1.11 (95%CI 1.02-1.20). The risk increased significantly with the number of penicillin exposures up to 1.20 (95%CI 1.11-1.31) for >10 courses. The risk also increased with the average number of penicillin treatments per-year (exposure intensity) with an OR of 1.04 (95%CI 1.01-1.08) per one additional treatment per year. Exposure to anti-viral or anti-fungal therapy was not associated with CRC risk.RESULTSA total of 20,990 cases and 82,054 controls were identified. The adjusted OR for CRC among subjects first exposed to penicillins >10 years prior to index date was 1.11 (95%CI 1.02-1.20). The risk increased significantly with the number of penicillin exposures up to 1.20 (95%CI 1.11-1.31) for >10 courses. The risk also increased with the average number of penicillin treatments per-year (exposure intensity) with an OR of 1.04 (95%CI 1.01-1.08) per one additional treatment per year. Exposure to anti-viral or anti-fungal therapy was not associated with CRC risk.Past exposure to multiple courses of penicillins is related to a modest elevation in CRC risk.CONCLUSIONSPast exposure to multiple courses of penicillins is related to a modest elevation in CRC risk. Purpose Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk. Methods We conducted a nested case–control study using a large population‐based database from the UK. Cases were defined as those with any medical code of CRC. Subjects with known familial CRC syndromes or IBD were excluded from the study. For every case, four eligible controls matched on age, sex, practice site, and duration of follow‐up before index date were selected using incidence‐density sampling. Exposure of interest was antibiotic therapy before index date. Adjusted ORs and 95%CIs were estimated using conditional logistic regression analysis. Results A total of 20 990 cases and 82 054 controls were identified. The adjusted OR for CRC among subjects first exposed to penicillins >10 years prior to index date was 1.11 (95%CI 1.02–1.20). The risk increased significantly with the number of penicillin exposures up to 1.20 (95%CI 1.11–1.31) for >10 courses. The risk also increased with the average number of penicillin treatments per‐year (exposure intensity) with an OR of 1.04 (95%CI 1.01–1.08) per one additional treatment per year. Exposure to anti‐viral or anti‐fungal therapy was not associated with CRC risk. Conclusions Past exposure to multiple courses of penicillins is related to a modest elevation in CRC risk. Copyright © 2015 John Wiley & Sons, Ltd. Purpose Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk. Methods We conducted a nested case-control study using a large population-based database from the UK. Cases were defined as those with any medical code of CRC. Subjects with known familial CRC syndromes or IBD were excluded from the study. For every case, four eligible controls matched on age, sex, practice site, and duration of follow-up before index date were selected using incidence-density sampling. Exposure of interest was antibiotic therapy before index date. Adjusted ORs and 95%CIs were estimated using conditional logistic regression analysis. Results A total of 20990 cases and 82054 controls were identified. The adjusted OR for CRC among subjects first exposed to penicillins >10years prior to index date was 1.11 (95%CI 1.02-1.20). The risk increased significantly with the number of penicillin exposures up to 1.20 (95%CI 1.11-1.31) for >10 courses. The risk also increased with the average number of penicillin treatments per-year (exposure intensity) with an OR of 1.04 (95%CI 1.01-1.08) per one additional treatment per year. Exposure to anti-viral or anti-fungal therapy was not associated with CRC risk. Conclusions Past exposure to multiple courses of penicillins is related to a modest elevation in CRC risk. Copyright © 2015 John Wiley & Sons, Ltd. Purpose Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim was to evaluate the association between the type and cumulative duration of antibiotic exposure and CRC risk. Methods We conducted a nested case-control study using a large population-based database from the UK. Cases were defined as those with any medical code of CRC. Subjects with known familial CRC syndromes or IBD were excluded from the study. For every case, four eligible controls matched on age, sex, practice site, and duration of follow-up before index date were selected using incidence-density sampling. Exposure of interest was antibiotic therapy before index date. Adjusted ORs and 95%CIs were estimated using conditional logistic regression analysis. Results A total of 20990 cases and 82054 controls were identified. The adjusted OR for CRC among subjects first exposed to penicillins >10years prior to index date was 1.11 (95%CI 1.02-1.20). The risk increased significantly with the number of penicillin exposures up to 1.20 (95%CI 1.11-1.31) for >10 courses. The risk also increased with the average number of penicillin treatments per-year (exposure intensity) with an OR of 1.04 (95%CI 1.01-1.08) per one additional treatment per year. Exposure to anti-viral or anti-fungal therapy was not associated with CRC risk. Conclusions Past exposure to multiple courses of penicillins is related to a modest elevation in CRC risk. Copyright copyright 2015 John Wiley & Sons, Ltd. |
| Author | Boursi, Ben Haynes, Kevin Mamtani, Ronac Yang, Yu-Xiao |
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| References_xml | – reference: Maguire A, Blak BT, Thompson M. The importance of defining periods of complete mortality reporting for research using automated data from primary care. Pharmacoepidemiol Drug Safe 2009; 18: 76-83. – reference: Jernberg C, Lofmark S, Edlund C, Jansson JK. Long-term ecological impacts of antibiotic administration on the human intestinal microbiota. ISME J 2007; 1: 56-66. – reference: Van-Staa TP, Wegman S, De-Vries F, Leufkens B, Cooper C. Use of statins and risk of fractures. JAMA 2001; 285: 1850-55. – reference: Abreu MT, Peek RM. Gastrointestinal malignancy and the microbiome. Gastroenterology 2014. doi:10.1053/j.gastro.2014.01.001. – reference: Hollowell J. The general practice research database: quality of morbidity data. Popul Trends 1997; 87: 36-40. – reference: Jernberg C, Lofmark S, Edlund C, Jansson JK. Long-term impacts of antibiotic exposure on the human intestinal microbiota. 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differences between colorectal cancer patients and healthy adults publication-title: PLoS One |
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Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue.... Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue. Our aim... Purpose Gut microbiota has been postulated to serve as a significant promoter of CRC formation, and colonic dysbiosis was previously reported in CRC tissue.... |
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| SubjectTerms | Aged Aged, 80 and over Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - adverse effects Anti-Bacterial Agents - therapeutic use antibiotic Antibiotics cancer Case-Control Studies colorectal Colorectal cancer Colorectal Neoplasms - chemically induced Colorectal Neoplasms - epidemiology Colorectal Neoplasms - microbiology Databases, Factual Dose-Response Relationship, Drug Electronic Health Records Female Humans Incidence Male Microbiota - drug effects Middle Aged Multivariate Analysis penicillin pharmacoepidemiology risk factor Risk Factors United Kingdom |
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| Title | Impact of antibiotic exposure on the risk of colorectal cancer |
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