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DDW 2020: Antibiotics and Risk of Colorectal Cancer After Negative Colonoscopy

By: Kelly M. Hennessey, PhD
Posted: Friday, May 22, 2020

Gut microbial imbalance is associated with the development of colorectal cancer. Although antibiotics appear to modulate the risk of colorectal cancer, their role in the development of colorectal cancer has not been clearly understood. Based on a recent study, Ka Shing Cheung, MD, of The University of Hong Kong, and colleagues found that any antibiotic use prior to colonoscopy was linked to lower rectal cancer but higher proximal cancer risk in older patients, depending on the class of antibiotics and the anatomic subsite of cancer. The results of their study were presented as part of the 2020 virtual Digestive Disease Week (DDW; Abstract Su1997).

The research team retrospectively analyzed a territory-wide health-care database of 7.4 million people. They recruited 97,162 patients, aged 60 or older, who had undergone index diagnostic or screening colonoscopy between 2005 and 2013, with no colorectal cancer detected. Of the total, 58,704 patients (60.4%) had prior antibiotic use.

Penicillins were associated with a lower risk of colorectal cancer after colonoscopy, whereas aminoglycosides were associated with a higher risk of colorectal cancer after colonoscopy . There was a lower risk of rectal cancer with broad-spectrum and oral antibiotics and a higher proximal cancer risk associated with antianaerobic, narrow-spectrum, and intravenous antibiotic use, the investigators reported.  

“Antibiotic effects on colorectal cancer in older patients varied according to cancer subsites, classes of antibiotics, and route of administration,” explained Dr. Cheung and colleagues. “Further studies are necessary to elucidate the potential role of different antibiotics and gut microbiota on colorectal cancer development.”

Disclosure: The study authors reported no conflicts of interest.



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