Frequent Use of Antibiotics Is Associated with Colorectal Cancer Risk: Results of a Nested Case-Control Study.
Frequent Use of Antibiotics Is Associated with Colorectal Cancer Risk: Results of a Nested Case-Control Study.
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DOI：
10.1007/s10620-015-3828-0
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发表时间：
2016-01
影响因子：
3.1
通讯作者：
Siersema PD
中科院分区：
文献类型：
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作者：
Dik VK;van Oijen MG;Smeets HM;Siersema PD
西方饮食引起的微生物失调似乎与结直肠癌（CRC）风险增加有关。很少有其他因素对结肠微生物群的影响及其与CRC的相关性进行了评估。我们调查了抗生素的使用是否与CRC风险相关。有关抗生素和联合用药使用的数据是从2006年至2011年间患有CRC诊断相关组的受试者以及四名年龄和性别匹配的对照组的健康保险数据库中提取的。根据5年随访期间（CRC前1-6年）的处方数量对抗生素使用进行分类。多变量条件二元逻辑回归分析用于估计不同使用水平的比值比（OR）和95%置信区间（95%CI）。共纳入4029例病例（47%为男性，诊断时平均年龄71 ± 11岁）和15,988例对照。2630例（65.3%）病例和10,234例（64.0%）对照患者使用了抗生素（p = 0.13）。抗生素使用的增加与CRC风险增加相关[高剂量（≥8次处方）与无处方的多变量OR：1.26，95% CI 1.11-1.44，p趋势<0.01]。每增加5次处方，CRC的OR为1.05（95% CI 1.01-1.09）。我们发现抗生素的使用，特别是经常使用的抗生素，与发生CRC的风险之间存在关联。需要进一步的研究来确定在何种情况下使用抗生素会增加患CRC的风险。
Microbiotical dysbiosis induced by a Western diet seems to be associated with an increased risk of developing colorectal cancer (CRC). Few other factors with an effect on the colonic microbiota and their association with CRC have been evaluated. We investigated whether the use of antibiotics is associated with CRC risk. Data on the use of antibiotics and comedication were extracted from a health insurance database for subjects with a diagnostic-related group for CRC between 2006 and 2011 and four age- and sex-matched controls. Antibiotic use was categorized according to the number of prescriptions during a 5-year follow-up period (1–6 years prior to CRC). Multivariable conditional binary logistic regression analysis was used to estimate odds ratios (ORs) and 95 % confidence intervals (95 % CIs) for different levels of use. A total of 4029 cases (47 % male, mean age at diagnosis 71 ± 11 years) and 15,988 controls were included. Antibiotics had been prescribed to 2630 (65.3 %) cases and 10,234 (64.0 %) controls (p = 0.13). An increasing use of antibiotics was associated with an increasing risk of CRC [multivariable OR for high (≥8 prescriptions) vs. no prescriptions: 1.26, 95 % CI 1.11–1.44, p-trend <0.01]. For each increase of 5 prescriptions, the OR for CRC was 1.05 (95 % CI 1.01–1.09). We found an association between the use of antibiotics, especially when used frequently, and the risk of developing CRC. Further studies are needed to establish under which conditions the use of antibiotics increases the risk of developing CRC.