Association between Antibiotic Use and Subsequent Risk of Prostate Cancer: A Retrospective Cohort Study in South Korea

Abstract

Background Several studies suggest that antibiotic use may affect overall cancer incidence, but the association between antibiotics and prostate cancer is still unclear. Methods A population-based retrospective cohort study was conducted using the Korean National Health Insurance Service (NHIS) database. 1,032,397 individuals were followed up from January 1, 2007, to December 31, 2019. Multivariate Cox hazards regression was utilized to calculate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the risk of prostate cancer according to accumulative days of antibiotic use and the number of antibiotic classes used. Results Individuals who used antibiotics for 180 or more days had a higher risk of prostate cancer (aHR, 1.46; 95% CI, 1.11-1.91) than those who did not use antibiotics. Also, individuals who used four or more kinds of antibiotics had a higher risk of prostate cancer (aHR, 1.18; 95% CI, 1.07-1.30) than antibiotic non-users. A similar trend was observed among participants who underwent health examinations. Conclusion Our findings suggest that long-term use of antibiotics may affect prostate cancer incidence. Further studies are needed to improve understanding of the association between antibiotic use and prostate cancer incidence.

Editorial Comment on “Association between antibiotic use and subsequent risk of prostate cancer: A retrospective cohort study in South Korea”

“…Recently, Park et al. evaluated the association between antibiotic use and prostate cancer risk using a retrospective cohort of the Korean National Health Insurance Service database 5 . Overall, 1 032 397 individuals were included in the study population between January 1, 2007, and December 31, 2019.…”

“…The authors showed that using antibiotics for 180 or more days was associated with an increased risk of prostate cancer [adjusted hazard ratios (aHRs), 1.46; 95% confidence intervals (CI), 1.11–1.91]. Additionally, individuals who used four or more antibiotic classes had a higher risk of prostate cancer (aHR, 1.18; 95% CI, 1.07–1.30) than those who did not use antibiotics 5 . This study has some limitations.…”

Editorial Comment from Dr Mori to Association between antibiotic use and subsequent risk of prostate cancer: A retrospective cohort study in South Korea

“…In this issue of the International Journal of Urology , Park and Hong et al. assessed the association between the use of antibiotics and their associated risk of prostate cancer by drawing on the Korean National Health Insurance Service (NHIS) database, which accounted for over 1 000 000 patients and concluded that long‐term use of antibiotics may affect the incidence of prostate cancer 4 . This is the first retrospective study evaluating the association between antibiotic use and prostate cancer in Asia and sheds new light on the long‐term use of antibiotics and associated risk of developing prostate cancer in Asian populations.…”