Antibiotic exposure within six months before systemic therapy was associated with lower cancer survival.

Morrell, S; Kohonen-Corish, MRJ; Ward, RL; Sorrell, TC; Roder, D; Currow, DC

Antibiotic exposure within six months before systemic therapy was associated with lower cancer survival.

Morrell, S Kohonen-Corish, MRJ Ward, RL Sorrell, TC Roder, D Currow, DC

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Journal of Clinical Epidemiology, 2022, 147, pp. 122-131
Issue Date:: 2022-04-06

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Field	Value	Language
dc.contributor.author	Morrell, S
dc.contributor.author	Kohonen-Corish, MRJ
dc.contributor.author	Ward, RL
dc.contributor.author	Sorrell, TC
dc.contributor.author	Roder, D
dc.contributor.author	Currow, DC
dc.date.accessioned	2022-09-27T05:00:47Z
dc.date.available	2022-04-04
dc.date.available	2022-09-27T05:00:47Z
dc.date.issued	2022-04-06
dc.identifier.citation	Journal of Clinical Epidemiology, 2022, 147, pp. 122-131
dc.identifier.issn	0895-4356
dc.identifier.issn	1878-5921
dc.identifier.uri	http://hdl.handle.net/10453/162125
dc.description.abstract	OBJECTIVES: The objective of the study was to quantify associations between cancer survival and antibiotic exposure before systemic anticancer therapy. STUDY DESIGN AND SETTING: This population-based cohort study compares cause-specific survival according to antibiotic exposure before non-immune checkpoint inhibitor (ICI) systemic therapy in patients diagnosed with single primary cancers in New South Wales between 2013 and 2016. Proportional hazards regression was used to control for confounding, with no antibiotic exposure in the six months before non-ICI systemic therapy serving as the comparator. RESULTS: After adjusting for tumour spread, cancer site, age, sex and comorbidity, people having antibiotic exposure within 180 days before non-ICI systemic therapy had poorer cancer survival (hazard ratios ranging from 1.21 [95% confidence interval: 1.06-1.39] to 1.58 [1.34-1.87]) for shorter periods since antibiotic exposure (P < .0001). Similarly, poorer survival trends applied for localized and metastatic cancer. Of six prevalent cancers studied, lung and breast primaries showed the strongest associations of lower survival with prior antibiotic exposure. CONCLUSION: Antibiotic exposure within 180 days before non-ICI systemic cancer treatment is associated with poorer survival. If confirmed in other studies, it provides another reason for vigilant antibiotic stewardship.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Journal of Clinical Epidemiology
dc.relation.isbasedon	10.1016/j.jclinepi.2022.04.003
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	01 Mathematical Sciences, 11 Medical and Health Sciences
dc.subject.classification	Epidemiology
dc.title	Antibiotic exposure within six months before systemic therapy was associated with lower cancer survival.
dc.type	Journal Article
utslib.citation.volume	147
utslib.location.activity	United States
utslib.for	01 Mathematical Sciences
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-09-27T05:00:45Z
pubs.publication-status	Published
pubs.volume	147

Abstract:

OBJECTIVES: The objective of the study was to quantify associations between cancer survival and antibiotic exposure before systemic anticancer therapy. STUDY DESIGN AND SETTING: This population-based cohort study compares cause-specific survival according to antibiotic exposure before non-immune checkpoint inhibitor (ICI) systemic therapy in patients diagnosed with single primary cancers in New South Wales between 2013 and 2016. Proportional hazards regression was used to control for confounding, with no antibiotic exposure in the six months before non-ICI systemic therapy serving as the comparator. RESULTS: After adjusting for tumour spread, cancer site, age, sex and comorbidity, people having antibiotic exposure within 180 days before non-ICI systemic therapy had poorer cancer survival (hazard ratios ranging from 1.21 [95% confidence interval: 1.06-1.39] to 1.58 [1.34-1.87]) for shorter periods since antibiotic exposure (P < .0001). Similarly, poorer survival trends applied for localized and metastatic cancer. Of six prevalent cancers studied, lung and breast primaries showed the strongest associations of lower survival with prior antibiotic exposure. CONCLUSION: Antibiotic exposure within 180 days before non-ICI systemic cancer treatment is associated with poorer survival. If confirmed in other studies, it provides another reason for vigilant antibiotic stewardship.

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http://hdl.handle.net/10453/162125