Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven Biomedical Sciences Group, Leuven, Flanders, Belgium.
Departement of Public Health and Primary Care, Katholieke Universiteit Leuven Groep Biomedische Wetenschappen, Leuven, Belgium.
BMJ Open. 2021 Dec 10;11(12):e053511. doi: 10.1136/bmjopen-2021-053511.
To examine the association between the use of oral antibiotics and subsequent colorectal cancer risk.
Matched case-control study.
General practice centres participating in the Integrated Computerised Network database in Flanders, Belgium.
In total, 1705 cases of colorectal cancer diagnosed between 01 January 2010 and 31 December 2015 were matched to 6749 controls by age, sex, comorbidity and general practice centre.
The association between the number of prescriptions for oral antibiotics and the incidence of colorectal cancer over a period of 1-10 years, estimated by a conditional logistic regression model.
A significantly increased risk of colorectal cancer (OR 1.25, 95% CI 1.10 to 1.44) was found in subjects with one or more prescriptions compared with those with none after correction for diabetes mellitus. No dose-response relationship was found.
This study resulted in a modestly higher risk of having colorectal cancer diagnosed after antibiotic exposure. The main limitation was missing data on known risk factors, in particular smoking behaviour. This study did not allow us to examine the causality of the relationship, indicating the need of further investigation.
探讨口服抗生素的使用与结直肠癌风险之间的关联。
匹配病例对照研究。
比利时佛兰德斯综合计算机网络数据库参与的全科医疗中心。
共纳入了 1705 例于 2010 年 1 月 1 日至 2015 年 12 月 31 日期间诊断为结直肠癌的病例，并通过年龄、性别、合并症和全科医疗中心与 6749 例对照进行匹配。
通过条件逻辑回归模型估计在 1-10 年内，口服抗生素的处方数量与结直肠癌发病率之间的关系。
校正糖尿病后，与无处方相比，有一个或多个处方的患者结直肠癌的发病风险显著增加（OR 1.25，95%CI 1.10 至 1.44）。未发现剂量-反应关系。
本研究表明，抗生素暴露后结直肠癌诊断的风险略有增加。主要的局限性在于存在已知风险因素（特别是吸烟行为）的数据缺失。本研究无法检验两者关系的因果关系，表明需要进一步研究。
