Abstract

The possible role of the altered intestinal microbiome in the development of malignancies has been raised recently in several publications. Among external factors, antibiotics are considered to be the most important agent capable of producing dysbiosis in the gut flora, either temporally or permanently. The human microbiome has several beneficial effects in terms of maintaining appropriate human health, but its alteration has been implicated in the development of many illnesses. Our basic aim was to explore a possible relationship between the consumption of different antibiotic classes and the incidence of the most common cancer types (male, female) in European countries. A database of the average, yearly antibiotic consumption (1997–2018) has been developed and the consumption figures were compared to the eight, most frequent cancer incidence calculated for 2018 in 30 European countries. Pearson correlation has indicated different degrees of positive (supportive) and negative (inhibitor) significant associations between antibiotic consumption figures and cancer prevalence. It has been observed that certain antibiotic classes with positive correlation probably augment the incidence of certain cancer types, while others, with negative correlation, may show some inhibitory effect. The relatively higher or lower consumption pattern of different classes of antibiotics could be related to certain cancer prevalence figures in different European countries. Our results indicated that countries with relatively high consumption of narrow-spectrum penicillin (J01CE, J01CF) and tetracycline (J01A), like certain Scandinavian countries, showed a higher incidence of female colorectal cancer, female lung cancer, melanoma, breast, prostate and uterus corpus cancer. Countries with relatively higher consumption of broad-spectrum penicillin (J01CA, J01CR) and some broad-spectrum antibiotics (J01D, J01F, J01M), like Greece, Hungary, Slovakia, France, etc. showed a higher incidence rate of male lung cancer and male bladder cancer. The higher incidence rate of different cancer types showed association with the higher consumption of antibiotics with “augmenting” properties and with less consumption of antibiotics with “inhibitory” properties.

Highlights

  • The first known cancer cases in humans have been verified in intact mummies from the pharaonic necropolis of Qubbet el-Hawa in Aswan, Egypt (BC 2000–1800), when CT scan was performed on the bodies

  • All types of cancers included in the study showed significant or statistically insignificant, positive or negative associations with at least one, ore more classes of antibiotics, including with the total consumption (J01) or with the high consumption rate of broad-spectrum antibiotics (J01 B/N)

  • It is of importance that the male and female cancer patients within the same location in certain cases, showed differently, sometimes opposite, associations with the same antibiotic groups

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Summary

Introduction

The first known cancer cases in humans have been verified in intact mummies from the pharaonic necropolis of Qubbet el-Hawa in Aswan, Egypt (BC 2000–1800), when CT scan was performed on the bodies. Researchers identified breast cancer and multiple myeloma [1]. The possible role of an altered intestinal microbiome has been raised in the process of carcinogenesis by several researchers and the possible effect of certain antibiotics has been mentioned [3,4,5,6,7,8,9]. Tumor-promoting effects of the microbiota in colorectal cancer (CRC) seem to be caused by altered host–microbiota interactions and by dysbiosis, rather than by infections with specific pathogens. Germ-free status and treatment with wide-spectrum antibiotics led to a significant reduction of the numbers of tumors in chemical and genetic experimental models of colorectal carcinogenesis. The strong microbiome–modification capability of antibiotics and their indirect role in the development of malignancies should be considered [10]

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