title: Associations of antibiotic use with risk of primary liver cancer in the Clinical Practice Research Datalink.
abstract: Use of antibiotics could alter human microbiota composition and decrease bacterial diversity. Such microbial dysbiosis may have implications in hepatocarcinogenesis; however, the association between antibiotic use and liver cancer risk has been minimally examined in humans.
  
  
  
  We performed a nested case-control study (1195 primary liver cancer cases and 4640 matched controls) within the United Kingdom's Clinical Practice Research Datalink. Antibiotic use was obtained from prescription records. Multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated using conditional logistic regression.
  
  
  
  Ever-use of prescription antibiotics was associated with a slightly increased risk of liver cancer, compared to non-use (OR=1.22, 95% CI=1.03-1.45). However, there was no clear dose-response relationship by the number of prescriptions or cumulative dose of antibiotic use, suggesting a non-causal association.
  
  
  
  Our results do not support a role of antibiotic use in liver cancer development.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-9774 USA.
authors.forename: Baiyu
authors.initials: B
authors.lastname: Yang
authors.affiliation: Boston Collaborative Drug Surveillance Program and Boston University School of Public Health, Lexington, MA, 02421 USA.
authors.forename: Katrina Wilcox
authors.initials: KW
authors.lastname: Hagberg
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-9774 USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-9774 USA.|Division of Cancer Prevention, National Cancer Institute, Bethesda, MD 20892-9783, USA.
authors.forename: Vikrant V
authors.initials: VV
authors.lastname: Sahasrabuddhe
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-9774 USA.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.affiliation: Boston Collaborative Drug Surveillance Program and Boston University School of Public Health, Lexington, MA, 02421 USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Jick
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-9774 USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McGlynn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D035843:Biomedical Research / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000139:chemically induced* / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D064307:Microbiota / Q000187:drug effects; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents