High Antibiotic Intake Linked to Cancer Development

The likelihood of cancer is higher among patients with a history of high consumption of antibiotics, according to study findings published in the Journal of Cancer Research and Clinical Oncology.

“There is a growing body of evidence suggesting the decisive involvement of the human microbiome in cancer development,” wrote researchers. “The consumption of antibiotics may fundamentally change the microbiome and thereby create a precancerous environment promoting cancer development and growth. However, clinical data on the association between the consumption of antibiotics and cancer incidence have remained inconclusive.”

To quantify the link, researchers analyzed data for 111,828 patients with cancer and 111,828 propensity-score matched control subjects without cancer from a large Germany primary care provider database.

Patients were categorized as antibiotic nonusers, low-consumption users (those at or below the 50th percentile), and high-consumption users (those above the 50th percentile). The study looked at the association between antibiotic use during the 5 years before the first cancer diagnosis for patients with cancer, and a randomly selected date for control subjects, and cancer incidence.

Overall, patients with a history of high antibiotic consumption had a significantly higher probability of cancer development at any site compared with nonusers, according to study authors.

“Patients using penicillin or cephalosporins displayed a higher incidence of cancer, while the intake of tetracyclines and macrolides actually reduced the risk of cancer development slightly,” reported researchers.

Notably, penicillin was positively associated with cancer development in the respiratory organs, and cephalosporin was associated with respiratory organ cancer, breast cancer, and lymphoid and hematopoietic tissue cancer.

Odds ratios for cancer development in the respiratory organs were 1.33 with low consumption of penicillin and 1.42 with high consumption of penicillin. For cephalosporin, odds ratios for respiratory organ cancer were 1.32 with low consumption and 1.47 for high consumption. Odds ratios with high cephalosporin consumption were 1.40 for breast cancer and 1.50 for lymphoid and hematopoietic tissue cancer.

“Thus, along with previous data, our study … suggests that the clinical management of patients needing antibiotics should include a careful and structured risk assessment for the development of cancer to improve long-term outcomes in these patients,” wrote researchers. “For example, patients with high/frequent consumption of penicillins or cephalosporins might be presented in a specific ‘board’ and discussed with dedicated infectiologists and oncologists, as was recently suggested in the context of specific antibiotic stewardship programs.”

Reference:
Roderburg C, Loosen SH, Joerdens MS, Demir M, Luedde T, Kostev K. Antibiotic therapy is associated with an increased incidence of cancer. J Cancer Res Clin Oncol. Published online April 19, 2022. doi:10.1007/s00432-022-03998-