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  • (예방) 항우울제 사용은 대장암 발생에 영향 미치지 않아: 미국 여성건강연구
  • Antidepressant Use and Risk of Colorectal Cancer in The Women's Health Initiative
  • 등록일 : May 22, 2018

    출처 : Cancer Epidemiology, Biomarkers & Prevention 보기

    조회수 : 272
  • 페이스북 공유 트위터 공유 카카오스토리 공유 URL복사
  • ※ 편집자 주: 몇몇 선행연구에서 항우울제를 복용하는 경우 대장암 위험이 낮아진다고 보고한 바 있다. 본 논문은 미국의 대규모 여성 건강 코호트 연구 자료를 활용하여 항우울제 복용과 대장암 발생과의 연관성을 살펴본 연구로, 항우울제 복용은 대장암 발생과 유의한 연관성이 관찰되지 않았으며, 대장암과 항문암을 나누어 평가했을 때도 마찬가지 결과가 나왔다. 이러한 결과는 항우울제가 대장암의 화학적 예방제로서 유용하지 않을 수 있음을 시사한다.

     

    [Abstract]

     

    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.

     

     

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