Slone Epidemiology Center at Boston University, Boston, MA 02215, USA.
Pharmacoepidemiol Drug Saf. 2009 Nov;18(11):1111-4. doi: 10.1002/pds.1808.
A previous epidemiologic study reported a 30% reduced risk of colorectal cancer among users of high doses of selective serotonin reuptake inhibitors (SSRIs). We assessed the association of colorectal cancer risk with SSRI and tricyclic antidepressant use in our hospital-based Case Control Surveillance Study.
For the SSRI analyses, we used data collected on 529 colorectal cancer cases and 1955 hospitalized controls collected from 1995 to 2008. For the tricyclic antidepressant analyses, we used data on 2889 cases and 7122 controls collected from 1976 to 2008. We used multivariable logistic regression analysis to evaluate the association of regular SSRI use and regular tricyclic antidepressant use (daily use for at least 3 continuous months) with colorectal cancer risk.
The odds ratio for regular SSRI use was 0.55 (95% CI 0.35-0.88) and it did not differ by duration of use. The odds ratio was 0.47 (95% CI 0.26-0.85) for colon cancer and 0.72 (95% CI 0.37-1.41) for rectal cancer. The odds ratio for regular use of tricyclic antidepressants was 0.77 (95% CI 0.52-1.16)
We found an association of reduced risk of colorectal cancer with regular use of SSRIs. In light of laboratory data indicating that SSRIs may inhibit colon cancer and one previous epidemiologic study that also observed a decreased risk, further investigation of the effect of SSRIs on the risk of colorectal cancer is warranted.
一项先前的流行病学研究报告称，高剂量选择性 5-羟色胺再摄取抑制剂（SSRIs）使用者患结直肠癌的风险降低 30%。我们在基于医院的病例对照监测研究中评估了 SSRI 和三环类抗抑郁药使用与结直肠癌风险之间的关联。
对于 SSRI 分析，我们使用了 1995 年至 2008 年期间收集的 529 例结直肠癌病例和 1955 例住院对照的数据。对于三环类抗抑郁药分析，我们使用了 1976 年至 2008 年期间收集的 2889 例病例和 7122 例对照的数据。我们使用多变量逻辑回归分析评估定期使用 SSRI 和定期使用三环类抗抑郁药（至少连续 3 个月每日使用）与结直肠癌风险的关联。
定期使用 SSRI 的比值比为 0.55（95%CI 0.35-0.88），且与使用时间无关。结肠癌的比值比为 0.47（95%CI 0.26-0.85），直肠癌的比值比为 0.72（95%CI 0.37-1.41）。定期使用三环类抗抑郁药的比值比为 0.77（95%CI 0.52-1.16）。
我们发现结直肠癌的风险与 SSRI 的定期使用呈负相关。鉴于实验室数据表明 SSRIs 可能抑制结肠癌，以及先前的一项流行病学研究也观察到风险降低，进一步调查 SSRI 对结直肠癌风险的影响是有必要的。
