Oral antibiotic use and early-onset colorectal cancer: findings from a case-control study using a national clinical database
Menée à partir de données 1999-2011 portant sur 30 418 témoins et sur 7 903 patients atteints d'un cancer colorectal, cette étude analyse l'association entre une utilisation d'antibiotiques et le risque de développer la maladie, en fonction de l'âge au moment du diagnostic (avant ou après 50 ans)
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: Seven thousands nine hundred and three 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.