{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:08:59Z","timestamp":1783354139574,"version":"3.54.6"},"reference-count":39,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005407","name":"Food and Health Bureau","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005407","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antibiotics may alter colorectal cancer (CRC) risk due to gut dysbiosis. We aimed to study the specific and temporal effects of various antibiotics on CRC development in older individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a territory\u2010wide retrospective cohort study. Subjects aged 60\u2009years and older who did not have CRC diagnosed on screening\/diagnostic colonoscopy diagnosed between 2005 and 2013 were recruited. Exclusion criteria were history of CRC, colectomy, inflammatory bowel disease, and CRC diagnosed within 6\u2009months of index colonoscopy. Exposure was use of any antibiotics up to 5\u2009years before colonoscopy. The primary outcomes were CRC diagnosed &gt;6\u00a0m after colonoscopy. Covariates were patient demographics, history of colonic polyps\/polypectomy, concomitant medication use (NSAIDs, COX\u20102 inhibitors, aspirin, and statins), and performance of endoscopy centers (colonoscopy volume and polypectomy rate). Stratified analysis was conducted according to nature of antibiotics and location of cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety seven thousand one hundred and sixty\u2010two eligible subjects (with 1026 [1.0%] cases of CRC) were identified, 58,704 (60.4%) of whom were exposed to antibiotics before index colonoscopy. Use of antibiotics was associated with a lower risk of cancer in rectum (adjusted hazard ratio [aHR]: 0.64, 95% CI: 0.54\u20130.76), but a higher risk of cancer in proximal colon (aHR: 1.63, 95%CI: 1.15\u20132.32). These effects differed as regards the anti\u2010anaerobic\/anti\u2010aerobic activity, narrow\u2010\/broad\u2010spectrum, and administration route of antibiotics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Antibiotics had divergent effects on CRC development in older subjects, which varied according to the location of cancer, antibiotic class, and administration route.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4759","type":"journal-article","created":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T04:34:03Z","timestamp":1651293243000},"page":"3863-3872","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association between antibiotic consumption and colon and rectal cancer development in older individuals: A\u00a0territory\u2010wide study"],"prefix":"10.1002","volume":"11","author":[{"given":"Ka Shing","family":"Cheung","sequence":"first","affiliation":[{"name":"Department of Medicine Queen Mary Hospital, The University of Hong Kong  Hong Kong City Hong Kong"},{"name":"Department of Medicine The University of Hong Kong&amp;Shenzhen Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy The University of Hong Kong  Hong Kong City Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Tam","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Mary Hospital, The University of Hong Kong  Hong Kong City Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4765-9913","authenticated-orcid":false,"given":"Irene O. L.","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Public Health The University of Hong Kong  Hong Kong City Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai\u00a0Kay","family":"Seto","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Mary Hospital, The University of Hong Kong  Hong Kong City Hong Kong"},{"name":"Department of Medicine The University of Hong Kong&amp;Shenzhen Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan F. N.","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Mary Hospital, The University of Hong Kong  Hong Kong City Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian C. 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