Abstract

BackgroundTo our knowledge, no epidemiological study has reported on whether an association between antidepressant exposure and gastric cancer exists. Herein, we aim to investigate the possible association between antidepressant exposure and gastric cancer incidence.MethodsUsing a nested case-control design, we identified 26289 cases with gastric cancer and 127984 controls from Taiwan’s National Health Insurance Research Database (NHIRD). The data were analyzed using a conditional logistic regression model adjusting for possible confounding variables.ResultsWe found antidepressant use did not increase the risk of gastric cancer. The lack of an association between antidepressant prescription and elevated gastric cancer incidence was apparent for across selective serotonin-reuptake inhibitors (SSRIs), tricyclic agents (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), reversible inhibitors of monoamine oxidase A (RIMA), trazodone, mirtazapine and bupropion. There were slightly decreased gastric cancer risks of SSRIs use (≧28 DDD group, adjusted OR = 0.87; 95% CI = 0.78–0.96). Sensitive analysis showed SSRIs, TCAs, and SNRIs did not increase gastric cancer risks significantly even in the group with peptic ulcer history.ConclusionsAn association between antidepressant exposure and gastric cancer was not apparent in this analysis.

Highlights

  • Gastric cancer is the third and fifth most common cause of mortality attributable to cancer in men and women, respectively, resulting in 738000 deaths per year worldwide[1]

  • We found antidepressant use did not increase the risk of gastric cancer

  • There were slightly decreased gastric cancer risks of selective serotonin-reuptake inhibitors (SSRIs) use (≧28 DDD group, adjusted OR = 0.87; 95% confidence interval (CI) = 0.78–0.96)

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Summary

Introduction

Gastric cancer is the third and fifth most common cause of mortality attributable to cancer in men and women, respectively, resulting in 738000 deaths per year worldwide[1]. It has been identified that peptic ulcer disease is a risk factor for incident gastric cancer. A large cohort study in Sweden reported that patients with gastric ulcer have an approximate 10-fold greater risk of gastric cancer in the first 2 years after diagnosis of peptic ulcer disease compared to those without peptic ulcer disease[2]. A separate cohort study in Taiwan reported that the relative risk for gastric cancer was 1.49–1.82 in individuals with gastric ulcer compared to those without[3]. In addition to studies reporting the relationship between gastric ulcer disease and gastric cancer, other studies have reported on a possible association between antidepressant prescription and gastric cancer incidence. We aim to investigate the possible association between antidepressant exposure and gastric cancer incidence. Editor: Kenji Hashimoto, Chiba University Center for Forensic Mental Health, JAPAN

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