Antidepressant Use and Risk of Colorectal Cancer in The Women's Health Initiative
Menée à partir de données portant sur une cohorte de 145 190 femmes dont 2 580 atteintes d'un cancer colorectal, cette étude évalue l'association entre l'utilisation d'antidépresseurs et le risque de développer la maladie
Background : Some prior studies have reported reduced colorectal cancer risk among individuals using antidepressant (AD) medications, especially selective serotonin reuptake inhibitors (SSRIs). Yet, most studies have not considered the potential role of depression or other confounders in their analyses. Methods : We utilized prospectively collected data from 145,190 participants in the Women's Health Initiative, among whom 2,580 incident colorectal cancer cases were diagnosed. AD use and depressive symptoms were assessed at baseline and follow-up study visits. Cox proportional hazards regression models with adjustment for depressive symptoms and other covariates were utilized to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for associations between AD use and colorectal cancer. Results : AD use was reported by 6.9% of participants at baseline, with SSRIs the most common class of AD used. In multivariable analyses, including adjustment for depressive symptomology, we observed no statistically significant association between AD use overall (HR 0.90, 95% CI 0.75-1.09) or with SSRIs specifically (HR 1.08, 95% CI 0.85-1.37) and colorectal cancer risk. A borderline significant reduction in colorectal cancer risk was observed for use of tricyclic antidepressants (HR 0.76, 95% CI 0.56-1.04). Severe depressive symptoms were independently associated with a 20% increased risk of colorectal cancer (HR 1.21, 95% CI 1.09-1.48). Results were similar for separate evaluations of colon and rectal cancer. Conclusions : We observed no evidence of an association between AD use, overall or by therapeutic class, and colorectal cancer risk. Impact : These results suggest that ADs may not be useful as chemopreventive agents for colorectal cancer.