Antibiotic Influence on Colorectal Cancer Risk

The relationship between antibiotic exposure and colorectal cancer risk has emerged as a focal point of investigation, reflecting concerns over how antimicrobial agents perturb the gut ecosystem. Antibiotics can induce dysbiosis—disruption of the normal gut microbiota—leading to alterations in bacterial metabolites, impairment of mucosal barrier integrity and modulation of local immune responses. Broad-spectrum agents appear particularly prone to fostering a pro-inflammatory milieu, promoting the formation of colorectal adenomas and accelerating tumour progression. Epidemiological studies have demonstrated dose- and duration-dependent associations, with repeated or high-volume antibiotic courses correlating with heightened incidence of both early-onset and later-life colorectal neoplasia. Mechanistic research in animal models has further illuminated how selective depletion of commensal bacteria can thin the protective mucus layer, attract neutrophils and generate DNA-damaging radicals, thereby establishing a causative link. Together, these findings underscore the global significance of antibiotic stewardship not only for curbing resistance but also for mitigating colorectal cancer risk, and they highlight avenues for microbiota-based prevention or adjuvant strategies.

Research from Nature Portfolio

Recent studies have shown that targeted modulation of gut bacteria alters colorectal tumour development in preclinical models. In a murine chemically induced colorectal cancer model, treatment with a vancomycin-sensitive antibiotic regimen substantially reduced tumour burden. This effect was traced to the loss of specific commensal species, diminished neutrophil infiltration, lower production of inflammatory cytokines and reduced nitric-oxide-mediated DNA damage. These mechanistic insights demonstrate that selective antibiotic intervention can attenuate key pathways in inflammation-driven colorectal carcinogenesis.

Antibiotic Influence on Colorectal Cancer Risk publication trend

The graph below shows the total number of articles in antibiotic influence on colorectal cancer risk across all publications each year (not limited to Nature Index journals).

Technical terms

Gut microbiota: The community of microorganisms residing in the gastrointestinal tract, essential for nutrient metabolism and immune regulation.

Dysbiosis: An imbalance in the composition or function of the gut microbiota that disrupts homeostasis and may promote disease.

Broad-spectrum antibiotic: An antimicrobial agent effective against a wide range of bacterial species, often at the expense of beneficial commensals.

Colorectal adenoma: A benign glandular tumour of the colon or rectum, recognised as a precursor lesion to colorectal cancer.

Mucosal barrier: The protective lining of the intestinal wall composed of mucus and epithelial cells, serving to prevent microbial translocation and inflammation.

References

1. Antibiotic‐mediated bacteriome depletion in ApcMin/+ mice is associated with reduction in mucus‐producing goblet cells and increased colorectal cancer progression. Cancer Medicine (2018).
2. Vancomycin-sensitive bacteria trigger development of colitis-associated colon cancer by attracting neutrophils. Scientific Reports (2016).
3. Antibiotic use and risk of colorectal cancer: a systematic review and dose–response meta-analysis. British Journal of Cancer (2020).
4. Association between antibiotic use during early life and early‐onset colorectal cancer risk overall and according to polygenic risk and FUT2 genotypes. International Journal of Cancer (2023).
5. Antibiotic Use Associated With Risk of Colorectal Polyps in a Nationwide Study. Clinical Gastroenterology and Hepatology (2020).