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The association between colorectal cancer and prior antibiotic prescriptions: case control study.
British Journal of Cancer ( IF 8.8 ) Pub Date : 2020-01-13 , DOI: 10.1038/s41416-019-0701-5
David Armstrong 1 , Alex Dregan 2 , Mark Ashworth 1 , Patrick White 1 , Chris McGee 3, 4 , Simon de Lusignan 3, 4
Affiliation  

BACKGROUND Antibiotic use over several decades is believed to be associated with colorectal adenomas. There is little evidence, however, for the effect of more recent antibiotic use on frequency of colorectal cancers. METHODS A case control study used the RCGP's Research and Surveillance Centre cohort of patients drawn from NHS England. In all, 35,214 patients with a new diagnosis of colorectal cancer between 1 January 2008 and 31 December 2018 were identified in the database and were matched with 60,348 controls. Conditional logistic regression was used to examine the association between antibiotic prescriptions and colorectal cancer. RESULTS A dose-response association between colorectal cancers and prior antibiotic prescriptions was observed. The risk was related to the number and recency of prescriptions with a high number of antibiotic prescriptions over a long period carrying the highest risk. For example, patients prescribed antibiotics in up to 15 years preceding diagnosis were associated with a higher risk of colorectal cancer (odds ratio (OR) = 1.90, 95% confidence intervals (CI), 1.61-2.19, p < 0.001). CONCLUSIONS Antibiotic use over previous years is associated with subsequent colorectal cancer. While the study design cannot determine causality, the findings suggest another reason for caution in prescribing antibiotics, especially in high volumes and over many years.

中文翻译:

大肠癌和以前的抗生素处方之间的关联:病例对照研究。

背景技术据信数十年来抗生素的使用与大肠腺瘤有关。然而,几乎没有证据表明最近使用抗生素对大肠癌发生率的影响。方法病例对照研究使用了RCGP研究和监视中心队列中的NHS英国患者。在数据库中共鉴定了35,214例在2008年1月1日至2018年12月31日期间新诊断为大肠癌的患者,并与60,348例对照进行了匹配。条件对数回归用于检验抗生素处方与结直肠癌之间的关系。结果观察到大肠癌和先前的抗生素处方之间存在剂量反应关系。风险与长期服用抗生素处方数量最多,风险最高的处方数量和新近度有关。例如,在诊断前长达15年使用抗生素的患者患大肠癌的风险更高(优势比(OR)= 1.90,95%置信区间(CI),1.61-2.19,p <0.001)。结论前几年使用抗生素与随后的大肠癌有关。尽管研究设计无法确定因果关系,但研究结果提示在开抗生素处方时应谨慎行事的另一个原因,尤其是在大量使用和多年使用抗生素时。在诊断前长达15年使用抗生素的患者与大肠癌的风险较高相关(比值比(OR)= 1.90,95%置信区间(CI),1.61-2.19,p <0.001)。结论过去几年使用抗生素与随后的大肠癌有关。虽然研究设计无法确定因果关系,但研究结果提示在开抗生素处方时应谨慎行事的另一个原因,尤其是在大量使用和多年使用抗生素时。在诊断前长达15年使用抗生素的患者与大肠癌的风险较高相关(比值比(OR)= 1.90,95%置信区间(CI),1.61-2.19,p <0.001)。结论过去几年使用抗生素与随后的大肠癌有关。尽管研究设计无法确定因果关系,但研究结果提示在开抗生素处方时应谨慎行事的另一个原因,尤其是在大量使用和多年使用抗生素时。
更新日期:2020-01-13
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