Cotterchio M, Kreiger N, Darlington G, Steingart A
Division of Preventive Oncology, Cancer Care Ontario, Toronto, Canada.
Am J Epidemiol. 2000 May 15;151(10):951-7. doi: 10.1093/oxfordjournals.aje.a010138.
Experimental and epidemiologic studies suggest that antidepressant medication use may be associated with breast cancer risk. This hypothesis was investigated using a population-based case-control study; cases diagnosed in 1995-1996 were identified using the Ontario Cancer Registry, and controls were randomly sampled from an Ontario Ministry of Finance database. Data were collected using a self-administered questionnaire, and multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals. Adjusted odds ratio estimates ranged from 0.7 to 0.8 and were not statistically significant for "ever" use of antidepressants, tricyclics, and selective serotonin reuptake inhibitors. Compared with no antidepressant use, use of tricyclic antidepressants for greater than 2 years' duration was associated with an elevated risk of breast cancer (odds ratio (OR) = 2.1, 95% confidence interval (CI): 0.9, 5.0). Of the six most commonly reported antidepressant medications, only paroxetine use was associated with an increase in breast cancer risk (OR = 7.2, 95% CI: 0.9, 58.3). Results from this study do not support the hypothesis that "ever" use of any antidepressant medications is associated with breast cancer risk. Use of tricyclic medications for greater than 2 years, however, may be associated with a twofold elevation, and use of paroxetine may be associated with a substantial increase in breast cancer risk.
实验和流行病学研究表明,使用抗抑郁药物可能与患乳腺癌的风险有关。本研究采用基于人群的病例对照研究对这一假设进行了调查;1995 - 1996年确诊的病例通过安大略癌症登记处确定,对照则从安大略省财政部数据库中随机抽取。数据通过自行填写的问卷收集,并使用多因素逻辑回归来估计比值比和95%置信区间。对于抗抑郁药、三环类药物和选择性5-羟色胺再摄取抑制剂的“曾经”使用情况,调整后的比值比估计值在0.7至0.8之间,且无统计学意义。与未使用抗抑郁药相比,使用三环类抗抑郁药超过2年与患乳腺癌风险升高相关(比值比(OR)=2.1,95%置信区间(CI):0.9,5.0)。在六种最常报告的抗抑郁药物中,仅使用帕罗西汀与乳腺癌风险增加相关(OR = 7.2,95% CI:0.9,58.3)。本研究结果不支持“曾经”使用任何抗抑郁药物与患乳腺癌风险相关这一假设。然而,使用三环类药物超过2年可能会使风险升高两倍,而使用帕罗西汀可能会使乳腺癌风险大幅增加。