Colorectal Cancer: Open Access

Introduction

Penicillin gut dysbiosis has been linked to colorectal cancer in the elderly. This study will look into whether there is a link between antibiotic use and early-onset colorectal cancer, as well as compare it to later-onset CRC.

A case-control study was carried out using data from primary care.Initial CRC cases (diagnosed at 50 years and later-onset CRC cases diagnosed at 50 years were studied separately. Adjusting for comorbidities, conditional logistic regression was used to calculate odds ratios and 95 percent confidence intervals CI for the associations between antibiotic exposure and CRC by tumour location.

The link between pathogenic organisms and cancer is well proven; Helicobacter pylori is linked to gastric cancer, and human papillomavirus (HPV) to anal, cervical, tonsillar, and vulval cancer. Antibiotic-induced microbiome changes can be constant, and irregularities in immunostimulatory bacterial products can impede normal immune surveillance, increasing the risk of carcinogenesis , Furthermore, disruption of normal gut commensals may allow pathogenic bacteria to colonise, invading and damaging the gut mucosa, leading to inflammation and tumour formation. Some of these harmful microbes include isolates of E. coli and Bacteroides fragilis, which may be supported by certain antibiotics.

"We now want to see if there's a link between antibiotic use and changes in the microbiome, which can make the colon more susceptible to cancer, particularly in younger people," said senior author "It's a complicated situation because we know that the microbiome can quickly revert to its previous state even after the bowel has been cleared out for a diagnostic procedure.

The study was presented at the ESMO World Congress on Gastrointestinal Cancer. Alberto Sobrero remarked for ESMO that younger patients with colon cancer typically have a worse prognosis than older people because they are diagnosed at a younger age. Previous research has shown that significant changes in the structure and diversity of the gut microbiome caused by antibiotics influence the development of colorectal cancer in older adults.

In order to identify colorectal cancer cases diagnosed in Scotland between 1999 and 2011, the researchers conducted a cluster case–control study of primary care records. Patients were divided into two groups: those diagnosed before the age of fifty and those diagnosed after the age of fifty, and they were matched with up to five healthy controls. The study included 7,903 CRC cases, 5,281 colon cancer cases, and 2,622 rectal cancer cases, as well as 30,418 controls.44 %of the CRC patients were under the age of 50.

Our results indicate that antibiotic exposure is linked to the development of CRC in all ages. It is possible that antibiotic use is contributing to CRC cases, possibly more so in children. Our findings raise the question of whether the history of antibiotic use should be included in standardised proformas for referral from primary to secondary care. More research is needed to confirm our findings and assess the long-term effects of antibiotics on gut health, as well as increased awareness of the potential harms associated with antibiotic use among clinicians and the general public.