Associations of antibiotic use with risk of primary liver cancer in the Clinical Practice Research Datalink

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: Our results do not support a role of antibiotic use in liver cancer development.