Antibiotics linked to higher EAC risk

Exposure to any antibiotics appears to contribute to an increase in the risk of esophageal adenocarcinoma (EAC), with the risk rising as the cumulative days of exposure increases, according to a study.

Researchers conducted a nested case-control study using data from the Veterans Health Administration from 2004 through 2020. The case group included patients who received an incident diagnosis of EAC, with each case matched to up to 20 individuals who did not have an EAC diagnosis. The matching was performed using incidence density sampling.

Conditional logistic regression facilitated estimation of the crude and adjusted odds ratios (aOR) for the risk of EAC associated with any oral or intravenous antibiotic use. Further analysis was conducted to account for effect of the cumulative number of days of exposure and classification of antibiotics.

A total of 8,226 EAC cases and 140,670 matched controls were included in the case-control analysis. Compared with nonexposure, exposure to any antibiotic was associated with a more than 70-percent increased risk of EAC (adjusted odds ratio [aOR], 1.74, 95 percent confidence interval [CI], 1.65–1.83).

Of note, the longer the cumulative exposure to any antibiotics, the higher the increase in EAC risk (p<0.001 for trend). The corresponding aORs were 1.63 (95 percent CI, 1.52–1.74; p<0.001) for cumulative exposure of 1–15 days, 1.77 (95 percent CI, 1.65–1.89; p<0.001) for cumulative exposure of 16‒47 days, and 1.87 (95 percent CI, 1.75–2.01; p<0.001) for cumulative exposure of ≥48 days.

More studies are needed to establish potential mechanisms that may play a role in the development or progression of EAC.