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

Br J Cancer. 2016 Jun 28;115(1):85-9. doi: 10.1038/bjc.2016.148. Epub 2016 May 24.


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.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Biomedical Research / methods
  • Case-Control Studies
  • Female
  • Humans
  • Liver Neoplasms / chemically induced*
  • Liver Neoplasms / etiology*
  • Logistic Models
  • Male
  • Microbiota / drug effects
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • United Kingdom


  • Anti-Bacterial Agents