 |
|
Antibiotic Use in Relation to the Risk of Breast Cancer
Christine M. Velicer, PhD;
Susan R. Heckbert, MD, PhD;
Johanna W. Lampe, PhD, RD;
John D. Potter, MD, PhD;
Carol A. Robertson, RPh;
Stephen H. Taplin, MD, MPH
JAMA. 2004;291:827-835.
Context Use of antibiotics may be associated with risk of breast cancer through effects on immune function, inflammation, and metabolism of estrogen and phytochemicals; however, clinical data on the association between antibiotic use and risk of breast cancer are sparse.
Objective To examine the association between use of antibiotics and risk of breast cancer.
Design, Setting, and Participants Case-control study among 2266 women older than 19 years with primary, invasive breast cancer (cases) enrolled in a large, nonprofit health plan for at least 1 year between January 1, 1993, and June 30, 2001, and 7953 randomly selected female health plan members (controls), frequency-matched to cases on age and length of enrollment. Cases were ascertained from the Surveillance, Epidemiology, and End Results cancer registry. Antibiotic use was ascertained from computerized pharmacy records.
Main Outcome Measure Association between extent of antibiotic use and risk of breast cancer.
Results Increasing cumulative days of antibiotic use were associated with increased risk of incident breast cancer, adjusted for age and length of enrollment. For categories of increasing use (0, 1-50, 51-100, 101-500, 501-1000, and  1001 days), odds ratios (95% confidence intervals) for breast cancer were 1.00 (reference), 1.45 (1.24-1.69), 1.53 (1.28-1.83), 1.68 (1.42-2.00), 2.14 (1.60-2.88), and 2.07 (1.48-2.89) (P<.001 for trend). Increased risk was observed in all antibiotic classes studied and in a subanalysis having breast cancer fatality as the outcome. Among women with the highest levels of tetracycline or macrolide use, risk of breast cancer was not elevated in those using these antibiotics exclusively for acne or rosacea (indications that could be risk factors for breast cancer due to altered hormone levels), compared with those using them exclusively for respiratory tract infections, adjusted for age and length of enrollment (odds ratio, 0.91; 95% confidence interval, 0.44-1.87).
Conclusions Use of antibiotics is associated with increased risk of incident and fatal breast cancer. It cannot be determined from this study whether antibiotic use is causally related to breast cancer, or whether indication for use, overall weakened immune function, or other factors are pertinent underlying exposures. Although further studies are needed, these findings reinforce the need for prudent long-term use of antibiotics.
Author Affiliations: Departments of Epidemiology (Drs Velicer, Heckbert, Lampe, and Potter) and Family Medicine (Dr Taplin), University of Washington, Seattle; Center for Health Studies (Drs Velicer, Heckbert, and Taplin) and Department of Pharmacy, Group Health Cooperative, Seattle (Ms Robertson); Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle (Drs Lampe and Potter); and Applied Research Program, National Cancer Institute, Bethesda, Md (Dr Taplin).
RELATED LETTERS
Use of Antibiotics and Risk of Cancer
Neil H. Shear, Donald A. Redelmeier, Jeffrey P. Callen, and and the Ad Hoc Task Force of the American Academy of Dermatology on the Reported Link Between Antibiotic Use and Breast Cancer
JAMA. 2004;291(22):2699.
EXTRACT
| FULL TEXT
Use of Antibiotics and Risk of Cancer
Spencer E. Harpe
JAMA. 2004;291(22):2699.
EXTRACT
| FULL TEXT
Use of Antibiotics and Risk of Cancer
Gary H. Lyman, Eva Culakova, and Jennifer Griggs
JAMA. 2004;291(22):2700.
EXTRACT
| FULL TEXT
Use of Antibiotics and Risk of Cancer—Reply
Christine M. Velicer, Susan R. Heckbert, John D. Potter, and Stephen H. Taplin
JAMA. 2004;291(22):2700.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Antibiotics and Breast Cancer—What's the Meaning of This?
Roberta B. Ness and Jane A. Cauley
JAMA. 2004;291(7):880-881.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Antibiotic Use and the Risk of Lung Cancer
Zhang et al.
Cancer Epidemiol. Biomarkers Prev. 2008;17:1308-1315.
ABSTRACT
| FULL TEXT
Understanding Microbe-Induced Cancers
Blaser
Cancer Prevention Research 2008;1:15-20.
ABSTRACT
| FULL TEXT
Antibiotics and Risk of Breast Cancer: Up to 9 Years of Follow-up of 2.1 Million Women.
Friedman et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:2102-2106.
ABSTRACT
| FULL TEXT
Short term oral minocycline treatment of meibomianitis
Aronowicz et al.
Br. J. Ophthalmol. 2006;90:856-860.
ABSTRACT
| FULL TEXT
Influence of Antibiotic Treatment on Breast Carcinoma Development in Proto-neu Transgenic Mice.
Rossini et al.
Cancer Res. 2006;66:6219-6224.
ABSTRACT
| FULL TEXT
Acne maintenance therapy: expanding the role of topical retinoids?
Zane
Arch Dermatol 2006;142:638-640.
FULL TEXT
Association of Amoxicillin Use During Early Childhood With Developmental Tooth Enamel Defects
Hong et al.
Arch Pediatr Adolesc Med 2005;159:943-948.
ABSTRACT
| FULL TEXT
Use of Antibiotics and Risk of Breast Cancer
Garcia Rodriguez and Gonzalez-Perez
Am J Epidemiol 2005;161:616-619.
ABSTRACT
| FULL TEXT
Use of Antibiotics and Risk of Cancer
Shear et al.
JAMA 2004;291:2699-2699.
FULL TEXT
Use of Antibiotics and Risk of Cancer
Lyman et al.
JAMA 2004;291:2700-2700.
FULL TEXT
Use of Antibiotics and Risk of Cancer
Harpe
JAMA 2004;291:2699-2699.
FULL TEXT
Minerva
BMJ 2004;328:E299-E299.
FULL TEXT
Antibiotic use in relation to the risk of breast cancer
Obstet Gynecol 2004;103:993-993.
FULL TEXT
How Safe Is Antibiotic Use in Women? Breast Cancer Concerns
Journal Watch Dermatology 2004;2004:2-2.
FULL TEXT
Minerva
BMJ 2004;328:532-532.
FULL TEXT
Antibiotic Use Is Linked with Breast Cancer Risk
JWatch General 2004;2004:1-1.
FULL TEXT
Antibiotics and Breast Cancer--What's the Meaning of This?
Ness and Cauley
JAMA 2004;291:880-881.
FULL TEXT
|
