To the Editor: Although Dr Velicer and colleagues1 controlled for confounding by indication for antibiotic
use and the use of oral contraceptives, they apparently did not consider adjusting
for comorbidity. There are several measures of comorbidity that the authors
might have used.2 The authors also did not
consider the potential impact of use of nonsteroidal anti-inflammatory drugs
(NSAIDs). While information about total NSAID use may not have been available
from the database, use of prescription NSAIDs would be recorded. Although
collected from a descriptive standpoint, other well-known factors associated
with risk of breast cancer, such as ages at menarche and menopause, parity,
family history of breast cancer, and body mass index, were not included in
the analysis and could have affected the results.
Harpe SE. Use of Antibiotics and Risk of Cancer. JAMA. 2004;291(22):2699. doi:10.1001/jama.291.22.2699-b
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