TY - JOUR
T1 - Association between Salmonella infection and colon cancer
T2 - a nationwide registry-based cohort study
AU - Duijster, Janneke W
AU - Hansen, Jørgen V
AU - Franz, Eelco
AU - Neefjes, Jacques J C
AU - Frisch, Morten
AU - Mughini-Gras, Lapo
AU - Ethelberg, Steen
N1 - Publisher Copyright:
© 2021 BMJ Publishing Group. All rights reserved.
PY - 2021/2/8
Y1 - 2021/2/8
N2 - Laboratory data increasingly suggests that Salmonella infection may contribute to colon cancer (CC) development. Here, we examined epidemiologically the potential risk of CC associated with salmonellosis in the human population. We conducted a population-based cohort study using four health registries in Denmark. Person-level demographic data of all residents were linked to laboratory-confirmed non-typhoidal salmonellosis and to CC diagnoses in 1994-2016. Hazard ratios (HRs) for CC (overall/proximal/distal) associated with reported salmonellosis were estimated using Cox proportional hazards models. Potential effects of serovar, age, sex, IBD and follow-up time post-infection were also assessed. We found no increased risk of CC ≥1 year post-infection (HR 0.99; 95%CI:0.88-1.13). When stratifying by serovar, there was a significantly increased risk of proximal CC ≥1 year post-infection with serovars other than Enteritidis and Typhimurium (HR 1.40; 95%CI:1.03-1.90). CC risk was significantly increased in the first year post-infection (HR 2.08; 95%CI:1.48-2.93). The association between salmonellosis and CC in the first year post-infection can be explained by increased stool testing around the time of CC diagnosis. The association between proximal CC and non-Enteritidis/non-Typhimurium serovars is unclear and warrants further investigation. Overall, this study provides epidemiological evidence that notified Salmonella infections do not contribute significantly to CC risk in the studied population.
AB - Laboratory data increasingly suggests that Salmonella infection may contribute to colon cancer (CC) development. Here, we examined epidemiologically the potential risk of CC associated with salmonellosis in the human population. We conducted a population-based cohort study using four health registries in Denmark. Person-level demographic data of all residents were linked to laboratory-confirmed non-typhoidal salmonellosis and to CC diagnoses in 1994-2016. Hazard ratios (HRs) for CC (overall/proximal/distal) associated with reported salmonellosis were estimated using Cox proportional hazards models. Potential effects of serovar, age, sex, IBD and follow-up time post-infection were also assessed. We found no increased risk of CC ≥1 year post-infection (HR 0.99; 95%CI:0.88-1.13). When stratifying by serovar, there was a significantly increased risk of proximal CC ≥1 year post-infection with serovars other than Enteritidis and Typhimurium (HR 1.40; 95%CI:1.03-1.90). CC risk was significantly increased in the first year post-infection (HR 2.08; 95%CI:1.48-2.93). The association between salmonellosis and CC in the first year post-infection can be explained by increased stool testing around the time of CC diagnosis. The association between proximal CC and non-Enteritidis/non-Typhimurium serovars is unclear and warrants further investigation. Overall, this study provides epidemiological evidence that notified Salmonella infections do not contribute significantly to CC risk in the studied population.
KW - colon cancer
KW - inflammatory bowel disease
KW - non-typhoidal Salmonella
KW - salmonellosis
UR - http://www.scopus.com/inward/record.url?scp=85100703652&partnerID=8YFLogxK
U2 - 10.1017/S0950268821000285
DO - 10.1017/S0950268821000285
M3 - Article
C2 - 33551005
SN - 0950-2688
VL - 149
SP - 1
EP - 8
JO - Epidemiology and Infection
JF - Epidemiology and Infection
IS - e56
ER -