Antibiotics are associated with an increased risk of colon cancer and infections after surgery

Using data from the Swedish National Registry of more than 35,000 colon cancer patients, doctoral student Sai Sun Moon Lu found that the use of prescription antibiotics was associated with an increased risk of developing colon cancer in the right side, the first part of the colon. The increase in risk was small but was already seen after one or two typical courses of antibiotics. Colon cancer patients who took antibiotics were also more likely to develop surgical site infections, a potentially life-threatening complication of surgery.

The results regarding the association between antibiotic use and colon cancer were expected. Bacterial imbalance, or dysbiosis, is thought to be most important in the first part of the colon, and other large studies have reported similar results. “The discovery of postoperative infections is new, which makes it very exciting for me,” says Sae Sun Moon Low, MD, Department of Diagnostics and Intervention.

Dysbiosis has been linked to poor wound healing and complications after bowel cancer surgery, but the study by Lu and colleagues is the first to look at antibiotics in the years before surgery.

In contrast, taking antibiotics did not increase the risk of rectal cancer or surgical site infections after rectal cancer surgery in the Cy Sun Moon Law studies. An unexpected result was a slightly lower risk of rectal cancer in women who took antibiotics.

“Another large study saw the same thing, but we didn't really expect to be able to replicate its results,” says Sae-Sun-Mun Lu.

– We researchers always say that more research is needed, and that is certainly true here.

Sai Sun Moon Low found no clear association between antibiotics taken before diagnosis and the prognosis of patients after a diagnosis of colon or rectal cancer.

“The findings in my thesis do not mean that we should stop using antibiotics, but they do suggest that careful and judicious use of antibiotics can have benefits beyond preventing the spread of antibiotic-resistant bacteria,” says Sae-Sun Mun Lu.

Doctoral thesis: Antibiotic use in relation to colorectal cancer risk, survival, and postoperative complications. Swedish address: Antibiotic use and colorectal cancer – risks, survival and postoperative complications. Exhibitor: Professor Jonas F. Ludvigsson, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. Principal Supervisor: Bethany Van Gilpen. Co-supervisor: Sophia Harreld. Date and time: 22 March 2024, 13:00-16:00 (Swedish local time). Location: Horsal Bitola, Norrland University Hospital.

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Sai San Moon Low (interview preferably conducted in English)
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+46 72 296 95 46