Incidence of cancer and antidepressant medication: Record linkage study

Abstract

The consumption of antidepressants, especially selective serotonine reuptake inhibitors (SSRI) has been increasing. Because a large fraction of the population is exposed, even a small excess of risk with respect to cancer should be considered. We carried out a record linkage study in Finland utilizing nationwide databases of reimbursed medication and cancer. The study population included all antidepressant drug (AD) users in Finland who had purchased at least 1 prescription between 1998 and 2005, and who had no cancer diagnosis at the date of first purchase. A control population without AD usage (matched by age and sex) was also included. Data consisted of 418,588 pairs of individuals that cumulated 3.3 million person-years with an average of 4.0 years of follow-up. 19,365 cancer cases were observed. The most frequent cancers were breast, prostate, lung, colon, and brain cancer. In general, only few associations between the utilization of AD and cancer could be detected. Over four years exposure to AD showed a weak association with increased colon and breast cancer incidence, which could have been caused by bias. As conclusion, no clear evidence of neither beneficial nor harmful association between usage of antidepressant and cancer was found.

Antidepressant use and circulating prolactin levels

“…We also cannot exclude a modest within-woman increase, regardless of BMI. Furthermore, if AD use is separately related to breast cancer risk as has been hypothesized [40, 41], then these data do not support increased prolactin levels as the potential underlying mechanism. Future work in these cohorts will evaluate ADs as a risk factor for breast cancer to provide a more definitive answer.…”

Carcinogenicity of psychotropic drugs: A systematic review of US Food and Drug Administration–required preclinical in vivo studies

“…Nevertheless, an 11% increase in risk can easily be accounted for potential confounding factors that exist in observational practice, such as smoking, diet and other environmental risk factors, none of which was controlled in the meta-analysis. Specific clinical studies, some of which are positive (Cotterchio et al, 2000;Dalton et al, 2000) and others negative (Coogan et al, 2005;Haukka et al, 2010), are hampered by similar methodological limitations.…”

Meta-analysis

“…Chubak et al [16] Walker et al [18] Haukka et al [19] Cronin-Fenton et al [17] Coogan et al [9] Xu et al [10] Overall in the funnel plot, and Egger's regression test also did not provide evidence for publication bias (P for bias = 0.142).…”

“…After the full texts for the remaining nine articles were reviewed, three articles were excluded. As a result, we included six observational studies (five casecontrol studies [9,10,[16][17][18] and one cohort study [19]). …”

“…The countries in which the studies had been conducted were as follows: USA (n = 2) [9,16], UK (n = 1) [18], Finland (n = 1) [19], Denmark (n = 1) [17], and Canada (n = 1) [10]. Of the studies included, three [16,17,18] were population-based case-control studies, one [19] was a cohort study, one [9] was a hospitalbased case-control study, and one [10] was a nested casecontrol study. The mean value for the methodological quality of the six studies that were included using the NOS was 7.8 stars (Table 1).…”