Depression, antidepressant use, and postmenopausal breast cancer risk
A partir des données de la cohorte "Women's Health Initiative Observational Study" incluant 71 439 participantes, cette étude évalue l'association entre des symptômes de dépression, l'utilisation de médicaments anti-dépresseurs et le risque de cancer du sein après la ménopause
Background : Whether depression and antidepressant (AD) use might influence breast cancer risk is unclear, and these exposures have not been evaluated together in a single, prospective cohort study of breast cancer risk. Methods : Among 71,439 postmenopausal women in the Women's Health Initiative Observational Study (WHI-OS), we estimated multivariable-adjusted hazard ratios (HRs) for the independent and joint effects of depressive symptoms and AD use on breast cancer risk using Cox proportional hazards regression. Results : When analyzed separately, neither depressive symptoms nor AD use at baseline were associated with a significantly increased risk of total breast cancer (HR=0.96, 95% CI: 0.85-1.08; HR=1.04, 95% CI: 0.92-1.20, respectively) or invasive breast cancer (HR=0.98, 95% CI: 0.86-1.12; HR=1.00, 95% CI: 0.86-1.16, respectively). Current AD use was associated with a borderline-significant increase of in situ breast cancer (HR=1.30, 95% CI: 0.99-1.75) after adjustment for depressive symptoms; however, this relationship was attenuated after adjustment for mammographic screening (HR=1.08, 95% CI: 0.76-1.51). No significant variation in total breast cancer risk was observed when the separate and joint effects of depressive symptoms and AD use were explored (p for interaction=0.14). Conclusions We found no evidence that either depression or AD use influence breast cancer risk. An elevated risk of in situ disease among AD users could not be ruled out, though is likely due to increased screening in this subgroup. Impact : Given the high prevalence of these exposures, these results may provide reassurance to the millions of women who are depressed and/or use ADs each year.