The Association between Selective Serotonin Reuptake Inhibitors (SSRIs) Use and the Risk of Bladder Cancer: A Nationwide Population-Based Cohort Study
The Association between Selective Serotonin Reuptake Inhibitors (SSRIs) Use and the Risk of Bladder Cancer: A Nationwide Population-Based Cohort Study
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DOI：
10.3390/cancers12051184
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发表时间：
2020-05-01
期刊：
影响因子：
5.2
通讯作者：
Chen, Yi-Lung
中科院分区：
文献类型：
--
作者：
Liu, Yi-Chun;Chen, Vincent Chin-Hung;Chen, Yi-Lung
背景：过去的研究表明，选择性5-羟色胺再摄取抑制剂(SSRI)处方和致癌风险之间存在混合关系。目前尚无流行病学研究报道SSRI的使用与膀胱癌发病率之间的关系。这项研究的目的是确定使用SSRI是否会影响膀胱癌的风险。方法：利用台湾国民健康保险研究资料库，于1997年1月1日至2013年12月31日期间，在全国范围内进行了一项回顾性队列研究。192,392名SSRI处方患者与191,786名从未接受过任何SSRI治疗的患者通过倾向分数匹配进行了1对1的随机匹配。用Cox比例风险模型检验了服用SSRIs和未服用SSRIs的个体患膀胱癌的风险。结果：在0.5、1和2年的诱导期内，SSRI与膀胱癌的风险显著降低(调整风险比(AHR)=0.86，95%CI(可信区间)=0.76~0.98，AHR=0.85，95%CI=0.75~0.97，AHR=0.77，95%CI=0.66~0.89)。在检测特异性SSRI的效果时，服用氟西汀的个体患膀胱癌的风险显著降低(6个月诱导期：AHR=0.78，95%CI=0.65~0.93；1年诱导期：AHR=0.78，95%CI=0.65~0.94；2年诱导期：AHR=0.73，95%CI=0.60~0.89)；帕罗西汀(6个月诱导期：AHR=0.78，95%CI=0.61~0.99；1年诱导期：AHR=0.79，95%CI=0.61~1.01；2年诱导期：AHR=0.72，95%CI=0.54~0.95；西酞普兰(6个月诱导期：AHR=0.74，95%CI=0.53~1.03；1年诱导期：AHR=0.70，95%CI=0.50~0.99；2年诱导期：AHR=0.60，95%CI=0.41~0.88)。结论：在这个大型的跨国数据库中，服用氟西汀、帕罗西汀或西酞普兰的患者患膀胱癌的风险降低。
Background: Past studies suggest mixed associations between selective serotonin reuptake inhibitor (SSRI) prescription and carcinogenic risk. There is no epidemiological study reporting on the association between SSRI use and the incidence of bladder cancer. The aim of this study is to determine whether SSRI use influences the risk of bladder cancer. Methods: We conducted a nationwide retrospective cohort study by Taiwan's National Health Insurance Research Database from January 1, 1997 to December 31, 2013. 192,392 SSRI prescribed individuals were randomly matched 1 to 1 with 191,786 individuals who had never received any SSRIs by propensity scores match. The Cox Proportional Hazard models were conducted to examine the risk of bladder cancer between individuals prescribed SSRIs and individuals not prescribed SSRIs. Results: SSRIs were associated with significant reduced risk of bladder cancer with 0.5, 1, and 2 year induction periods (adjusted hazard ratio (aHR) = 0.86, 95% CI (confidence interval) = 0.76-0.98, aHR = 0.85, 95% CI = 0.75-0.97, and aHR = 0.77, 95% CI = 0.66-0.89). When examining the effect of specific SSRI, there was significantly lower risk of bladder cancer in individuals prescribed fluoxetine (6 month induction period: aHR = 0.78, 95% CI = 0.65-0.93; 1 year induction period: aHR = 0.78, 95% CI = 0.65-0.94; 2 year induction period: aHR = 0.73, 95% CI = 0.60-0.89), paroxetine (6 month induction period: aHR = 0.78, 95% CI = 0.61-0.99; 1 year induction period: aHR = 0.79, 95% CI = 0.61-1.01; 2 year induction period: aHR = 0.72, 95% CI = 0.54-0.95), and citalopram (6 month induction period: aHR = 0.74, 95% CI = 0.53-1.03; 1 year induction period: aHR = 0.70, 95% CI = 0.50-0.99; 2 year induction period: aHR = 0.60, 95% CI = 0.41-0.88). Conclusions: Individuals prescribed fluoxetine, paroxetine, or citalopram had a reduced risk of bladder cancer in this large, cross-national database.