姐妹研究队列中的抑郁症、抗抑郁药使用情况与乳腺癌发病率

Depression, antidepressant use, and breast cancer incidence in the Sister Study cohort.

作者信息

Díaz-Santana Mary V, Park Jihye, Rogers Molly, O'Brien Katie M, Nichols Hazel B, D'Aloisio Aimee A, Bookwalter Deborah B, Sandler Dale P, Weinberg Clarice R

机构信息

Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, 111 T.W. Alexander Dr., Durham, NC, 27709, USA.

Epidemiology, Global Regulatory, Safety & Quality, GSK, Collegeville, PA, USA.

出版信息

Breast Cancer Res. 2025 May 15;27(1):82. doi: 10.1186/s13058-025-02043-4.

DOI:10.1186/s13058-025-02043-4

PMID:40375342

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12083028/

Abstract

BACKGROUND

Depression could affect breast cancer risk; however, epidemiologic findings are mixed. We assessed the association of breast cancer risk with self-reported history of diagnosed depression and time-dependent antidepressant use.

METHODS

We analyzed data from 45,746 women in the Sister Study cohort (2003-2009). Cox proportional hazard regression was used to estimate hazard ratios (HR) for breast cancer.

RESULTS

During follow-up (mean = 11.7 years), 3,899 breast cancers were diagnosed. There was no association between history of diagnosed depression and risk of breast cancer (HR = 0.98, 95%CI = 0.91-1.06). However, antidepressant use was associated with reduced risk of breast cancer (HR = 0.92, 95%CI = 0.85-1.00). Comparison of antidepressant drug classes revealed a suggestion of an inverse association with selective serotonin reuptake inhibitors (SSRIs, HR = 0.90, 95%CI = 0.81-1.00). Reduction was stronger in those with BMI < 25 (HR = 0.72, 95%CI = 0.59-0.89).

CONCLUSIONS

Depression was not associated with breast cancer risk. We observed a suggestion of a reduction in risk associated with antidepressant use. The analysis evaluating the association by specific drug types, showed a suggestion of a reduction in breast cancer risk associated with use of SSRIs. The negative association with overall antidepressant use and SSRIs, was stronger in those with BMI < 25, which could reflect a dose effect. This was the first study to examine the association between depression, antidepressant use, and breast cancer risk in a large genetic-risk-enriched cohort.

摘要

背景

抑郁症可能影响乳腺癌风险；然而，流行病学研究结果并不一致。我们评估了乳腺癌风险与自我报告的抑郁症诊断史以及随时间变化的抗抑郁药使用情况之间的关联。

方法

我们分析了姐妹研究队列（2003 - 2009年）中45746名女性的数据。采用Cox比例风险回归来估计乳腺癌的风险比（HR）。

结果

在随访期间（平均 = 11.7年），共诊断出3899例乳腺癌。抑郁症诊断史与乳腺癌风险之间无关联（HR = 0.98，95%CI = 0.91 - 1.06）。然而，使用抗抑郁药与降低乳腺癌风险相关（HR = 0.92，95%CI = 0.85 - 1.00）。对抗抑郁药类别进行比较发现，与选择性5-羟色胺再摄取抑制剂（SSRI）存在负相关的迹象（HR = 0.90，95%CI = 0.81 - 1.00）。体重指数（BMI）< 25的人群中这种降低更为明显（HR = 0.72，95%CI = 0.59 - 0.89）。

结论

抑郁症与乳腺癌风险无关。我们观察到使用抗抑郁药有降低风险的迹象。按特定药物类型评估关联的分析显示，使用SSRI有降低乳腺癌风险的迹象。与总体抗抑郁药使用和SSRI的负相关在BMI < 25的人群中更强，这可能反映了剂量效应。这是第一项在一个遗传风险较高的大型队列中研究抑郁症、抗抑郁药使用与乳腺癌风险之间关联的研究。