Long-term use of antibiotics and risk of colorectal adenoma

Yin Cao, Kana Wu, Raaj Mehta, David A. Drew, Mingyang Song, Paul Lochhead, Long H. Nguyen, Jacques Izard, Charles S. Fuchs, Wendy S. Garrett, Curtis Huttenhower, Shuji Ogino, Edward L. Giovannucci, Andrew T. Chan

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective Recent evidence suggests that antibiotic use, which alters the gut microbiome, is associated with an increased risk of colorectal cancer. However, the association between antibiotic use and risk of colorectal adenoma, the precursor for the majority of colorectal cancers, has not been investigated. Design We prospectively evaluated the association between antibiotic use at age 20-39 and 40-59 (assessed in 2004) and recent antibiotic use (assessed in 2008) with risk of subsequent colorectal adenoma among 16 642 women aged ≥60 enrolled in the Nurses' Health Study who underwent at least one colonoscopy through 2010. We used multivariate logistic regression to calculate ORs and 95% CIs. Results We documented 1195 cases of adenoma. Increasing duration of antibiotic use at age 20-39 (p trend =0.002) and 40-59 (p trend =0.001) was significantly associated with an increased risk of colorectal adenoma. Compared with non-users, women who used antibiotics for ≥2 months between age 20 and 39 had a multivariable OR of 1.36 (95% CI 1.03 to 1.79). Women who used ≥2 months of antibiotics between age 40 and 59 had a multivariable OR of 1.69 (95% CI 1.24 to 2.31). The associations were similar for low-risk versus high-risk adenomas (size ≥1 cm, or with tubulovillous/villous histology, or ≥3 detected lesions), but appeared modestly stronger for proximal compared with distal adenomas. In contrast, recent antibiotic use within the past four years was not associated with risk of adenoma (p trend =0.44). Conclusions Long-term antibiotic use in early-to-middle adulthood was associated with increased risk of colorectal adenoma.

Original languageEnglish (US)
Pages (from-to)672-678
Number of pages7
JournalGut
Volume67
Issue number4
DOIs
StatePublished - Apr 2018

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Adenoma
Anti-Bacterial Agents
Colorectal Neoplasms
Colonoscopy
Histology
Logistic Models
Nurses
Health

Keywords

  • ANTIBIOTICS
  • COLONIC MICROFLORA
  • COLORECTAL ADENOMAS
  • INFLAMMATION

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Cao, Y., Wu, K., Mehta, R., Drew, D. A., Song, M., Lochhead, P., ... Chan, A. T. (2018). Long-term use of antibiotics and risk of colorectal adenoma. Gut, 67(4), 672-678. https://doi.org/10.1136/gutjnl-2016-313413

Long-term use of antibiotics and risk of colorectal adenoma. / Cao, Yin; Wu, Kana; Mehta, Raaj; Drew, David A.; Song, Mingyang; Lochhead, Paul; Nguyen, Long H.; Izard, Jacques; Fuchs, Charles S.; Garrett, Wendy S.; Huttenhower, Curtis; Ogino, Shuji; Giovannucci, Edward L.; Chan, Andrew T.

In: Gut, Vol. 67, No. 4, 04.2018, p. 672-678.

Research output: Contribution to journalArticle

Cao, Y, Wu, K, Mehta, R, Drew, DA, Song, M, Lochhead, P, Nguyen, LH, Izard, J, Fuchs, CS, Garrett, WS, Huttenhower, C, Ogino, S, Giovannucci, EL & Chan, AT 2018, 'Long-term use of antibiotics and risk of colorectal adenoma', Gut, vol. 67, no. 4, pp. 672-678. https://doi.org/10.1136/gutjnl-2016-313413
Cao Y, Wu K, Mehta R, Drew DA, Song M, Lochhead P et al. Long-term use of antibiotics and risk of colorectal adenoma. Gut. 2018 Apr;67(4):672-678. https://doi.org/10.1136/gutjnl-2016-313413
Cao, Yin ; Wu, Kana ; Mehta, Raaj ; Drew, David A. ; Song, Mingyang ; Lochhead, Paul ; Nguyen, Long H. ; Izard, Jacques ; Fuchs, Charles S. ; Garrett, Wendy S. ; Huttenhower, Curtis ; Ogino, Shuji ; Giovannucci, Edward L. ; Chan, Andrew T. / Long-term use of antibiotics and risk of colorectal adenoma. In: Gut. 2018 ; Vol. 67, No. 4. pp. 672-678.
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title = "Long-term use of antibiotics and risk of colorectal adenoma",
abstract = "Objective Recent evidence suggests that antibiotic use, which alters the gut microbiome, is associated with an increased risk of colorectal cancer. However, the association between antibiotic use and risk of colorectal adenoma, the precursor for the majority of colorectal cancers, has not been investigated. Design We prospectively evaluated the association between antibiotic use at age 20-39 and 40-59 (assessed in 2004) and recent antibiotic use (assessed in 2008) with risk of subsequent colorectal adenoma among 16 642 women aged ≥60 enrolled in the Nurses' Health Study who underwent at least one colonoscopy through 2010. We used multivariate logistic regression to calculate ORs and 95{\%} CIs. Results We documented 1195 cases of adenoma. Increasing duration of antibiotic use at age 20-39 (p trend =0.002) and 40-59 (p trend =0.001) was significantly associated with an increased risk of colorectal adenoma. Compared with non-users, women who used antibiotics for ≥2 months between age 20 and 39 had a multivariable OR of 1.36 (95{\%} CI 1.03 to 1.79). Women who used ≥2 months of antibiotics between age 40 and 59 had a multivariable OR of 1.69 (95{\%} CI 1.24 to 2.31). The associations were similar for low-risk versus high-risk adenomas (size ≥1 cm, or with tubulovillous/villous histology, or ≥3 detected lesions), but appeared modestly stronger for proximal compared with distal adenomas. In contrast, recent antibiotic use within the past four years was not associated with risk of adenoma (p trend =0.44). Conclusions Long-term antibiotic use in early-to-middle adulthood was associated with increased risk of colorectal adenoma.",
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T1 - Long-term use of antibiotics and risk of colorectal adenoma

AU - Cao, Yin

AU - Wu, Kana

AU - Mehta, Raaj

AU - Drew, David A.

AU - Song, Mingyang

AU - Lochhead, Paul

AU - Nguyen, Long H.

AU - Izard, Jacques

AU - Fuchs, Charles S.

AU - Garrett, Wendy S.

AU - Huttenhower, Curtis

AU - Ogino, Shuji

AU - Giovannucci, Edward L.

AU - Chan, Andrew T.

PY - 2018/4

Y1 - 2018/4

N2 - Objective Recent evidence suggests that antibiotic use, which alters the gut microbiome, is associated with an increased risk of colorectal cancer. However, the association between antibiotic use and risk of colorectal adenoma, the precursor for the majority of colorectal cancers, has not been investigated. Design We prospectively evaluated the association between antibiotic use at age 20-39 and 40-59 (assessed in 2004) and recent antibiotic use (assessed in 2008) with risk of subsequent colorectal adenoma among 16 642 women aged ≥60 enrolled in the Nurses' Health Study who underwent at least one colonoscopy through 2010. We used multivariate logistic regression to calculate ORs and 95% CIs. Results We documented 1195 cases of adenoma. Increasing duration of antibiotic use at age 20-39 (p trend =0.002) and 40-59 (p trend =0.001) was significantly associated with an increased risk of colorectal adenoma. Compared with non-users, women who used antibiotics for ≥2 months between age 20 and 39 had a multivariable OR of 1.36 (95% CI 1.03 to 1.79). Women who used ≥2 months of antibiotics between age 40 and 59 had a multivariable OR of 1.69 (95% CI 1.24 to 2.31). The associations were similar for low-risk versus high-risk adenomas (size ≥1 cm, or with tubulovillous/villous histology, or ≥3 detected lesions), but appeared modestly stronger for proximal compared with distal adenomas. In contrast, recent antibiotic use within the past four years was not associated with risk of adenoma (p trend =0.44). Conclusions Long-term antibiotic use in early-to-middle adulthood was associated with increased risk of colorectal adenoma.

AB - Objective Recent evidence suggests that antibiotic use, which alters the gut microbiome, is associated with an increased risk of colorectal cancer. However, the association between antibiotic use and risk of colorectal adenoma, the precursor for the majority of colorectal cancers, has not been investigated. Design We prospectively evaluated the association between antibiotic use at age 20-39 and 40-59 (assessed in 2004) and recent antibiotic use (assessed in 2008) with risk of subsequent colorectal adenoma among 16 642 women aged ≥60 enrolled in the Nurses' Health Study who underwent at least one colonoscopy through 2010. We used multivariate logistic regression to calculate ORs and 95% CIs. Results We documented 1195 cases of adenoma. Increasing duration of antibiotic use at age 20-39 (p trend =0.002) and 40-59 (p trend =0.001) was significantly associated with an increased risk of colorectal adenoma. Compared with non-users, women who used antibiotics for ≥2 months between age 20 and 39 had a multivariable OR of 1.36 (95% CI 1.03 to 1.79). Women who used ≥2 months of antibiotics between age 40 and 59 had a multivariable OR of 1.69 (95% CI 1.24 to 2.31). The associations were similar for low-risk versus high-risk adenomas (size ≥1 cm, or with tubulovillous/villous histology, or ≥3 detected lesions), but appeared modestly stronger for proximal compared with distal adenomas. In contrast, recent antibiotic use within the past four years was not associated with risk of adenoma (p trend =0.44). Conclusions Long-term antibiotic use in early-to-middle adulthood was associated with increased risk of colorectal adenoma.

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