Oral antibiotic use and early-onset colorectal cancer: findings from a case-control study using a national clinical database

Ronald McDowell, Sarah Liane Perrott, Peter Murchie, Christopher Cardwell, Carmel Hughes, Leslie M Samuel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
Antibiotic-induced gut dysbiosis has been associated with colorectal cancer (CRC) in older adults. This study will investigate whether an association exists between antibiotic usage and early-onset colorectal cancer (CRC), and also evaluate this in later-onset CRC for comparison.

Methods
A case-control study was conducted using primary care data from 1999-2011. Analysis were conducted separately in early-onset CRC cases (diagnosed <50 years) and later-onset cases (diagnosed >=50 years). Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals (CI) for the associations between antibiotic exposure and CRC by tumour location, adjusting for comorbidities.

Results
7,903 CRC cases (445 aged <50 years) and 30,418 controls were identified. Antibiotic consumption was associated with colon cancer in both age-groups, particularly in the early-onset CRC cohort (<50 years: adjusted Odds Ratio (ORadj) 1·49 (95%CI 1·07, 2·07), p=0·018; >= 50 years (ORadj (95%CI) 1·09 (1·01, 1·18), p=0·029). Antibiotics were not associated with rectal cancer (<50 years: ORadj (95%CI) 1·17 (0·75, 1·84), p=0·493; >=50 years: ORadj (95%CI) 1·07 (0·96, 1·19), p=0·238).

Conclusion
Our findings suggest antibiotics may have a role in colon tumour formation across all age groups.
Original languageEnglish
Pages (from-to)957-967
JournalBritish Journal of Cancer
Volume126
Early online date17 Dec 2021
DOIs
Publication statusPublished - 01 Apr 2022

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