|
Title
|
|
|
|
Antibiotic use and risk of colorectal cancer : a systematic review and dose-response meta-analysis
| |
|
Author
|
|
|
|
| |
|
Abstract
|
|
|
|
| Background It is understudied whether the posed association of oral antibiotics with colorectal cancer (CRC) varies between antibiotic spectrums, colorectal continuum, and if a non-linear dose-dependent relationship is present. Design Three electronic databases and a trial platform were searched for all relevant studies, from inception until February 2020, without restrictions. Random-effects meta-analyses provided pooled effect-sizes (ES) with 95% confidence intervals (CI). Dose-response analyses modelling the relationship between number of days exposed to antibiotics and CRC risk were extended to non-linear multivariable random-effects models. Results Of 6483 identified publications ten were eligible, including 4.1 million individuals and over 73,550 CRC cases. The pooled CRC risk was increased among individuals who ever-used antibiotics (ES = 1.17, 95%CI 1.05-1.30), particularly for broad-spectrum antibiotics (ES = 1.70, 95%CI 1.26-2.30), but not for narrow-spectrum antibiotic (ES = 1.11, 95% 0.93-1.32). The dose-response analysis did not provide strong evidence of any particular dose-response association, and the risk patterns were rather similar for colon and rectal cancer. Discussion The antibiotic use associated CRC risk seemingly differs between broad- and narrow-spectrum antibiotics, and possibly within the colorectal continuum. It remains unclear whether this association is causal, requiring more mechanistic studies and further clarification of drug-microbiome interactions. |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
The British journal of cancer. - London
| |
|
Publication
|
|
|
|
London
:
2020
| |
|
ISSN
|
|
|
|
0007-0920
| |
|
DOI
|
|
|
|
10.1038/S41416-020-01082-2
| |
|
Volume/pages
|
|
|
|
123
:12
(2020)
, p. 1825-1832
| |
|
ISI
|
|
|
|
000572293800003
| |
|
Pubmed ID
|
|
|
|
32968205
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|
Full text (open access)
|
|
|
|
| |
|