Moorman Patricia G, Grubber Janet M, Millikan Robert C, Newman Beth
Cancer Prevention, Detection, and Control Research Program, Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Epidemiology. 2003 May;14(3):307-14.
Experimental studies in animals have suggested that antidepressants may promote the growth of mammary tumors, but epidemiologic data have not shown consistent associations between antidepressant use and breast cancer.
We analyzed data from a population-based, case-control study conducted in North Carolina from 1996 to 2000 to examine the association between antidepressant use and breast cancer. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) separately for invasive breast cancer and carcinoma in situ.
Over 20% of both cases and controls reported having ever used antidepressants. Overall, women with invasive breast cancer did not report antidepressant use more frequently than controls (OR = 1.0; CI = 0.7-1.2). There was a suggestion that use of selective serotonin reuptake inhibitor antidepressants for 36 months or more was more common among the breast cancer cases (OR = 2.7; CI = 0.9-7.9). Carcinoma in situ cases reported antidepressant use less frequently than controls (OR = 0.6; CI = 0.4-0.8). No consistent relation was observed between duration of use and carcinoma in situ.
Antidepressant use in general was not related to an increased risk of breast cancer. There may be increased risk associated with long-term use of SSRIs. Continued monitoring of this relation is warranted, given the high prevalence of use of these drugs in the general population.
动物实验研究表明，抗抑郁药可能会促进乳腺肿瘤生长，但流行病学数据并未显示抗抑郁药的使用与乳腺癌之间存在一致的关联。
我们分析了1996年至2000年在北卡罗来纳州进行的一项基于人群的病例对照研究的数据，以检验抗抑郁药的使用与乳腺癌之间的关联。分别使用逻辑回归模型来估计浸润性乳腺癌和原位癌的比值比（OR）和95%置信区间（CI）。
超过20%的病例和对照报告曾使用过抗抑郁药。总体而言，浸润性乳腺癌女性报告使用抗抑郁药的频率并不比对照组更高（OR = 1.0；CI = 0.7 - 1.2）。有迹象表明，乳腺癌病例中使用选择性5-羟色胺再摄取抑制剂抗抑郁药36个月或更长时间更为常见（OR = 2.7；CI = 0.9 - 7.9）。原位癌病例报告使用抗抑郁药的频率低于对照组（OR = 0.6；CI = 0.4 - 0.8）。未观察到使用持续时间与原位癌之间存在一致关系。
总体而言，使用抗抑郁药与乳腺癌风险增加无关。长期使用选择性5-羟色胺再摄取抑制剂可能会增加风险。鉴于这些药物在普通人群中的高使用率，有必要继续监测这种关系。
