Is antibiotics use really associated with increased risk of colorectal cancer? An updated systematic review and meta-analysis of observational studies
Purpose The association between antibiotics and colorectal cancer (CRC) risk has drawn increasing attention but remains controversial. This study was performed to clarify the association. Methods A systematic review and meta-analysis was performed on seven electronic databases. The pooled odds ratios (OR) with a 95% confidence interval (CI) were calculated to estimate the association using the fixed-effects model or the random-effects model. Results Ten studies that contained 4,853,289 participants were included in our study. We found that antibiotics use was associated with a higher risk of CRC (OR 1.09, 95%CI 1.02–1.17, I2 = 92.8%). More than 60 days of antibiotics use and 5 prescriptions of antibiotics were significantly associated with a higher risk of CRC. Sub-analysis on different types of antibiotics found that anti-anaerobic antibiotics, penicillins, and quinolones use led to increased risk of CRC (OR 1.22, 95% CI 1.04–1.44, I2 = 89.1%; OR 1.09, 95% CI 1.04–1.13, I2 = 69.2%; OR 1.15, 95% CI 1.03–1.35, I2 = 88.2%; respectively) and colon cancer (OR 1.28, 95% CI 1.04–1.58, $ I^{2} $ = 98.5%; OR 1.09, 95% CI 1.05–1.12, I2 = 0; OR 1.09, 95% CI 1.04–1.15, I2 = 0; respectively). However, antibiotics use was not significantly associated with rectal cancer (OR 1.03, 95% CI 0.92–1.16, I2 = 77.6%). Conclusion It needs attention that antibiotics use is associated with a higher risk of CRC, especially for colon cancer. Clinicians should be aware of the potential risk of CRC when prescribing anti-anaerobic antibiotics, penicillins, and quinolones in the future. Further studies are needed to assess any potential differences by tumor sites and class of antibiotics..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
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| Enthalten in: |
International journal of colorectal disease - 35(2020), 8 vom: 06. Juni, Seite 1397-1412 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Qu, Guangbo [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| BKL: | |
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| Themen: |
Antibiotics |
| doi: |
10.1007/s00384-020-03658-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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SPR040269868 |
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| 520 | |a Purpose The association between antibiotics and colorectal cancer (CRC) risk has drawn increasing attention but remains controversial. This study was performed to clarify the association. Methods A systematic review and meta-analysis was performed on seven electronic databases. The pooled odds ratios (OR) with a 95% confidence interval (CI) were calculated to estimate the association using the fixed-effects model or the random-effects model. Results Ten studies that contained 4,853,289 participants were included in our study. We found that antibiotics use was associated with a higher risk of CRC (OR 1.09, 95%CI 1.02–1.17, I2 = 92.8%). More than 60 days of antibiotics use and 5 prescriptions of antibiotics were significantly associated with a higher risk of CRC. Sub-analysis on different types of antibiotics found that anti-anaerobic antibiotics, penicillins, and quinolones use led to increased risk of CRC (OR 1.22, 95% CI 1.04–1.44, I2 = 89.1%; OR 1.09, 95% CI 1.04–1.13, I2 = 69.2%; OR 1.15, 95% CI 1.03–1.35, I2 = 88.2%; respectively) and colon cancer (OR 1.28, 95% CI 1.04–1.58, $ I^{2} $ = 98.5%; OR 1.09, 95% CI 1.05–1.12, I2 = 0; OR 1.09, 95% CI 1.04–1.15, I2 = 0; respectively). However, antibiotics use was not significantly associated with rectal cancer (OR 1.03, 95% CI 0.92–1.16, I2 = 77.6%). Conclusion It needs attention that antibiotics use is associated with a higher risk of CRC, especially for colon cancer. Clinicians should be aware of the potential risk of CRC when prescribing anti-anaerobic antibiotics, penicillins, and quinolones in the future. Further studies are needed to assess any potential differences by tumor sites and class of antibiotics. | ||
| 650 | 4 | |a Antibiotics |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Colorectal cancer |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Colon cancer |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Rectal cancer |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Meta-analysis |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Sun, Chenyu |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Monica |e verfasserin |4 aut | |
| 700 | 1 | |a Uy, John Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Song, Evelyn J. |e verfasserin |4 aut | |
| 700 | 1 | |a Bhan, Chandur |e verfasserin |4 aut | |
| 700 | 1 | |a Shu, Liqin |e verfasserin |4 aut | |
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