Long-Term or Recurrent Antibiotic Use During Childhood or Adolescence and the Risk of Kidney Cancer: A Cohort Study.
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BACKGROUND: Antibiotic use has been associated with cancer risk, but evidence regarding early-life antibiotic use and kidney cancer is limited. This study aimed to examine the association between long-term or recurrent antibiotic use (LRAU) during childhood or adolescence and kidney cancer risk and to assess the potential mediating role of adult adiposity. METHODS: This cohort study included 147,605 participants from the UK Biobank. We included participants with information on LRAU during childhood or adolescence who were free of cancer prior to baseline. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between LRAU during childhood or adolescence and kidney cancer risk. Mediation analyses were performed to evaluate the potential mediating role of adiposity. RESULTS: LRAU during childhood or adolescence was associated with a 48% higher risk of incident kidney cancer after adjustment for potential confounders (HR 1.48, 95% CI 1.08-2.02). The proportion of the observed association between LRAU and kidney cancer mediated by adiposity measures ranged from 4.3% for waist-to-hip ratio to 13.2% for body fat percentage. CONCLUSIONS: LRAU during childhood or adolescence was associated with a higher risk of kidney cancer, and mediation analyses suggested that adult adiposity may partially mediate this association. Further studies using prospectively recorded prescription and indication data are needed to replicate these findings.