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Antibiotic Use Asso...
Antibiotic Use Associated With Risk of Colorectal Polyps in a Nationwide Study
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- Song, Mingyang (författare)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston Massachusetts, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston Massachusetts, USA; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA
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- Nguyen, Long H. (författare)
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA
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- Emilsson, Louise, 1982- (författare)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of General Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway; Vårdcentralen Årjäng and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
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- Chan, Andrew T. (författare)
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA; Broad Institute of MIT and Harvard, Cambridge Massachusetts, USA; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston Massachusetts, USA
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- Ludvigsson, Jonas F., 1969- (författare)
- Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Division of Digestive and Liver Disease, Department of Medicine, Columbia University Medical Center, New York, USA; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Department of Epidemiology, Harvard TH. Chan School of Public Health, Boston Massachusetts, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston Massachusetts, USA; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts, USA (creator_code:org_t)
- Elsevier, 2021
- 2021
- Engelska.
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 19:7, s. 1426-1435.e6
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Abstract
Ämnesord
Stäng
- 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 (including 28,884 cases [63.1%] and 53,222 sibling controls [57.0%]) had a higher risk of colorectal polyps (odds ratio [OR], 1.08; 95% CI, 1.04-1.13). Risk increased with higher number of dispensations (OR for >= 6 dispensations, 1.33; 95% CI, 1.25-1.43) (P-trend <.0001). We observed a stronger association with polyps for broad-spectrumantibiotics (OR comparing users to non-users, 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 (P-heterogeneity >.10). We found stronger associations for younger (<50 years) vs older adults (>= 50 years) for users of quinolones, sulfonamides, trimethoprim, and cephalosporins (P-interaction <.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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Nyckelord
- Antiaerobic
- Anaerobic
- Bacteria
- Sessile Serrated Polyp
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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