Association between broad-spectrum antibiotic use and risk of early-onset colorectal cancer
Menée à partir de données américaines portant sur 2 794 témoins et 295 patients atteints d'un adénocarcinome colorectal (âge : 15-49 ans), cette étude analyse l'association entre une utilisation d’antibiotiques oraux et le risque de survenue précoce de la maladie, en fonction du spectre des antibiotiques
Background: Exposure to broad-spectrum antibiotics may alter the risk of early-onset colorectal cancer (eoCRC) via gut dysbiosis. We evaluated the associations between oral broad-spectrum and narrow-spectrum antibiotic use and eoCRC.
Methods: We conducted a nested case-control study within Kaiser Permanente Southern California. Cases were persons aged 15-49 years with in situ or invasive colorectal adenocarcinoma (2009-2021); controls were individually matched 10:1 on age, sex, and length of KPSC membership. Those with ≥15 years of membership were included to assess exposure 2-15 years earlier. Data were collected from electronic health records. Crude and multivariable conditional logistic regression was used to evaluate antibiotic use from 10-14.9, 5-9.9, and 2-4.9 years before diagnosis/index date with risk of overall CRC, colon, and rectal cancer.
Results: A total of 295 cases and 2,794 controls were included. In the 10-14.9 years before diagnosis/index date, use of broad-spectrum antibiotics was not associated with eoCRC [adjusted odds ratio (aOR) for any use=1.07 (95% CI: 0.82-1.40)]; aOR for >90 days cumulative use =1.40 (0.82-2.38)]. An elevated risk of colon adenocarcinoma was suggested for > 90 days cumulative use of broad-spectrum antibiotics [aOR=2.04 (1.09-3.85)]. No clear association was observed for broad-spectrum antibiotic use within 5-9.9 or 2-4.9 years prior to diagnosis or with rectal cancer during any period, or for narrow-spectrum antibiotics in any exposure window.
Conclusions: An association between long-term cumulative use of broad-spectrum antibiotics and early-onset colon cancer is suggested.
Impact: Further investigation into antibiotics and eoCRC risk by duration of use and window of exposure is warranted.
Cancer Epidemiology, Biomarkers & Prevention , résumé, 2026