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A recent large study revealed an association between antibiotic exposure and colorectal cancer, particularly in the proximal colon (NEJM JW Gastroenterol Oct 2019 and Gut 2019; 68:1971). The results were plausible, given experimental evidence that the gut microbiome might have a role in carcinogenesis. Now, Swedish researchers have used nationwide cancer and drug-prescribing registries in a case-control comparison between 40,000 patients with newly diagnosed colorectal cancer (67% in the colon, 33% in the rectum) and 200,000 matched controls. The median time for exposure to antibiotics (prior to colorectal cancer diagnosis) was 6 years, but this interval was as long as 9 years in some cases.
A significant dose-response association between co…