dc.date.accessioned | 2021-03-20T21:39:14Z | |
dc.date.available | 2021-03-20T21:39:14Z | |
dc.date.created | 2021-01-07T12:26:23Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Song, Mingyang Nguyen, Long Hoang Emilsson, Louise Chan, Andrew Ludvigsson, Jonas F. . Antibiotic Use Associated With Risk of Colorectal Polyps in a Nationwide Study. Clinical Gastroenterology and Hepatology. 2020 | |
dc.identifier.uri | http://hdl.handle.net/10852/84334 | |
dc.description.abstract | Background & Aims
Use of antibiotics affects the composition of the microbiome and might affect development of colorectal polyps, which are precursors to colorectal cancer.
Methods
We performed a nested case–control study in Sweden of 45,744 patients with a colorectal polyp (cases) in the nationwide gastrointestinal ESPRESSO histopathology cohort, using unaffected full siblings as controls (n = 93,307). Polyps were classified by morphology SnoMed codes into conventional adenomas and serrated polyps. Through linkage to the Prescribed Drug Register, we assessed use and cumulative dispensations of antibiotic until 1 year prior to polyp diagnosis for cases and their sibling controls.
Results
During a median study period of 6.9 years, compared with non-users, users of antibiotics (28,884 cases [63.1%] and 53,222 sibling controls [57.0%]) had a higher risk of colorectal polyps. Risk increased with higher number of dispensations (odds ratio [OR] for ≥ 6 dispensations, 1.33; 95% CI, 1.25–1.43) (Ptrend < .0001). We observed a stronger association with polyps for broad-spectrum antibiotics (odds ratio [OR], 1.23; 95% CI, 1.18–1.29) than for narrow-spectrum antibiotics (OR, 1.05; 95% CI, 1.01–1.10), and for tetracyclines and quinolones (OR, 1.21) than penicillin and other classes (ORs ranged from 1.04 to 1.16). The findings remained robust with several sensitivity analyses, including use of a 2-year lead-in period for antibiotic assessment and correction for misclassification in controls. Use of broad-spectrum antibiotics was more strongly associated with risk of serrated polyps (OR, 1.29; 95% CI, 1.21–1.38) compared with risk of conventional adenomas (OR, 1.17; 95% CI, 1.11–1.24). We found no differences in risk of colon vs rectal polyps with antibiotic use (Pheterogeneity > .10). We found stronger associations for younger (<50 years) vs older adults (≥50 years) for users of quinolones, sulfonamides, trimethoprim, and cephalosporins (Pinteraction < .001).
Conclusions
In a nationwide case–control study in Sweden, after accounting for hereditary and early life environmental factors, antibiotic use was associated with increased risk of colorectal polyps. Our findings indicate a role for intestinal dysbiosis in early stages of colorectal carcinogenesis. | |
dc.language | EN | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | |
dc.title | Antibiotic Use Associated With Risk of Colorectal Polyps in a Nationwide Study | |
dc.type | Journal article | |
dc.creator.author | Song, Mingyang | |
dc.creator.author | Nguyen, Long Hoang | |
dc.creator.author | Emilsson, Louise | |
dc.creator.author | Chan, Andrew | |
dc.creator.author | Ludvigsson, Jonas F. | |
cristin.unitcode | 185,52,15,0 | |
cristin.unitname | Avdeling for allmennmedisin | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.cristin | 1866980 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Clinical Gastroenterology and Hepatology&rft.volume=&rft.spage=&rft.date=2020 | |
dc.identifier.jtitle | Clinical Gastroenterology and Hepatology | |
dc.identifier.doi | https://doi.org/10.1016/j.cgh.2020.05.036 | |
dc.identifier.urn | URN:NBN:no-87090 | |
dc.type.document | Tidsskriftartikkel | |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 1542-3565 | |
dc.identifier.fulltext | Fulltext https://www.duo.uio.no/bitstream/handle/10852/84334/2/Song_CGH_Preprint_antibiotica_polyps.pdf | |
dc.type.version | PublishedVersion | |