Risk Factors for Breast Cancer in Orange County, Florida

说明(由申请人提供)先前的流行病学和实验证据表明，抗抑郁药物和乳腺癌风险之间可能存在关联，这些证据在方法学上存在一些缺陷。这项研究的广泛目标是在解决以前研究中的缺陷的同时，调查这种联系。主要的假设是抗抑郁药物会增加患乳腺癌的风险。这是一项以人群为基础的病例对照研究。从佛罗里达州癌症登记处挑选的55-74岁的病例将是400例乳腺癌病例(ICD-9代码174)，诊断时间为1997年1月1日至2000年12月31日，或数据完整的最近一个月。控制者将是400名奥兰治县女性居民，并将从佛罗里达州的驾照文件中选择。他们将与种族和年龄(每隔5年)的病例进行频率匹配。电话访谈将由训练有素的面试者进行，以收集关于过去使用抗抑郁药物、抑郁症病史和许多潜在混杂因素的数据，使用结构化问卷和诊断性面谈时间表(DIS)。数据将通过非条件Logistic回归分析进行分析。优势比(OR)和95%的CI将被报告为与抗抑郁药使用相关的乳腺癌风险，并将根据年龄、种族、乳腺癌家族史、酒精和其他潜在混杂因素进行调整。其他分析将包括按抑郁状态分层的分析、剂量-反应分析，以及抗抑郁药物与以下每一项之间的相互作用分析：抑郁、乳腺癌家族史、良性乳腺病史和生育史。这一结果将从对未来抗抑郁药物使用的影响的角度进行讨论。

DESCRIPTION (provided by applicant)Previous epidemiologic and experimental evidence suggesting a possible association between antidepressant drugs and the risk of breast cancer have several methodological weaknesses. The broad objective of this study is to investigate this association while addressing the flaws in previous studies. The primary hypothesis is that antidepressants increase the risk of breast cancer. This is a population-based case-control study. The 55-74 year-old cases to be selected from the Florida State Cancer Registry will be 400 breast cancer cases (ICD-9 code 174), diagnosed between 1/1/97 and 12/31/00, or the latest month in 2001 for which data are complete. The controls will be 400 female Orange County residents, and will be selected from Florida State Drivers' License files. They will be frequency-matched with cases on race and age (5-year intervals). Telephone interviews will be conducted by trained interviewers to collect data on past use of antidepressants, depression history and many potential confounders, using a Structured Questionnaire and the Diagnostic Interview Schedule (DIS). The data will be analyzed by means of unconditional logistic regression analysis. Odds ratios (ORs) and 95% CIs will be reported for breast cancer risk associated with antidepressant use, and will be adjusted for age, race, family history of breast cancer, alcohol, and other potential confounders. Additional analyses will include analysis stratified by depression status, dose-response analysis, and analysis for interactions between antidepressants and each of: depression, family history of breast cancer, history of benign breast disease and reproductive history. The results will be discussed in terms of implications for future use of antidepressants.