January 15, 2022

Are antibiotics linked to early-onset colorectal cancer?

Antibiotic use may lead to an increased risk of colon cancer at all ages, a review of a large Scottish primary care database suggested.

Specifically, the study found that antibiotic use was associated with an increased risk of colon cancer in patients over age 50 (adjusted OR 1.09, 95% CI 1.01-1, 18) and particularly under the age of 50 (adjusted OR 1.49, 95% CI 1.07 -2.07), reported Sarah Perrott, from the University of Aberdeen in Scotland, in a presentation at the Virtual World Congress on Gastrointestinal Cancer.

“With the increase in cases of colorectal cancer in young, non-obese patients without risk factors, our study provides additional reasons to reduce, where possible, frequent and unnecessary prescriptions for antibiotics,” he said. she declared.

Perrott pointed out that the incidence of early-onset colorectal cancer has increased worldwide, while at the same time there has been an increase in the consumption of antibiotics. “Significant modification of the structure and diversity of the gut microbiome with antibiotic therapy has already been shown to influence the genesis of colorectal cancer in the elderly,” she noted.

For this nested case-control study, researchers identified 7,903 cases of colorectal cancer (5,281 colon cancers and 2,622 rectal cancers) diagnosed from 1999 to 2011 and compared them to 30,418 controls. Of the colorectal cancer patients, 445 were under the age of 50 and 45% were prescribed antibiotics during the exposure period.

Perrott and colleagues also found that antibiotic use was associated with an increased risk of proximal colon cancer in patients younger than 50 years of age (adjusted OR 3.78, 95% CI 1.60-8, 92), but not in older patients (adjusted OR 0.89, 95% CI 0.72-1.11).

“No association was seen with rectal cancer,” Perrott pointed out, “which we find interesting, as rectal cancer is a common cancer site in early-onset versus early-onset colorectal cancer. later. “

Most classes of antibiotics were not significantly associated with colon, rectal, or distal colon cancer, the authors reported. However, quinolones (adjusted OR 7.47, 95% CI 1.40-39.94) and sulfonamides / trimethoprim (adjusted OR 4.66, 95% CI 1.66-13.09) were associated with Proximal colon cancer in the early onset group.

“More epidemiological and translational studies are needed to assess the true role of antibiotics in the development of colorectal cancer and also to assess the long-term effects of antibiotics on gut health,” Perrott said.

The use of antibiotics may contribute to the increase in early-onset colorectal cancer, said study presenter Thomas Seufferlein, MD, PhD, of the University of Ulm in Germany.

“However, there are many lifetime exposures with potential effects on colorectal cancer tumorigenesis,” he noted. “More studies are needed regarding the change in the microbiota upon exposure to different antibiotics and at different ages.”

“I agree with the authors that prudent use of antibiotics is reasonable and paramount,” added Seufferlein. “But we are looking for more data on this very interesting topic.”

  • Mike Bassett is a writer specializing in oncology and hematology. He is based in Massachusetts.

Disclosures

Perrott did not report any disclosures.


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