Early-life recurrent antibiotic use and risks of adult kidney cancer and sex-specific cancers: a prospective cohort study in the UK Biobank

Abstract

There is little evidence about the associations of long-term or recurrent antibiotics use (LRAU) during early life with cancer risk. Our study aimed to assess the associations via Cox proportional hazards regression, using data from the UK Biobank (UKB). The main outcomes were the incidence of adult kidney cancer and sex-specific cancers, classified according to International Classification of Diseases, 10th revision (ICD-10). LRAU during early life was self-reported. 136,011 participants (55.29% women) were included in the study, with a mean follow-up of 7.5 years (SD 2.17). Among participants with LRAU during early life, a higher proportion were women (68.98% vs. 31.02% men, P < 0.001). Among all participants, LRAU during early life was associated with a higher risk of kidney cancer in the fully adjusted model (HR 1.38; 95% CI 1.05–1.82). No significant associations were observed between LRAU during early life and other non-sex-specific cancers. Sex-stratified analysis revealed that LRAU during early life was associated with an increased risk of kidney cancer (HR 1.59; 95% CI 1.07–2.35), bladder cancer (HR 1.47; 95% CI 1.01–2.13) and breast cancer (HR 1.09; 95% CI 1.00-1.20) in females. For males, LRAU during early life was associated with an increased risk of esophageal cancer (HR 1.72; 95% CI 1.07–2.78). After stratifying the analyses by age at menarche, LRAU during early life was associated with an increased risk of breast cancer among women with menarche after age 12 years (HR 1.15; 95% CI 1.02–1.29), but the interaction effect was not statistically significant ( P for interaction = 0.217). This study provides evidence suggesting that LRAU during early life may be associated with an increased risk of kidney cancer, bladder and breast cancer in adult females, and esophageal cancer in adult males.