Use of antidepressants and risk of colorectal cancer: a nested case-control study

Wanning Xu ¹, Hani Tamim , Stan Shapiro

⁰Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.

The Lancet. Oncology +

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April 1, 2006

View abstract on PubMed

Summary

Selective serotonin reuptake inhibitors (SSRI) may decrease colorectal cancer risk, particularly with high daily doses. Tricyclic antidepressants showed no consistent association with colorectal cancer risk in this study.

Area Of Science

Oncology
Pharmacology
Epidemiology

Background

Animal studies suggest selective serotonin reuptuptake inhibitors (SSRI) may inhibit colorectal tumor growth, while tricyclic antidepressants might increase colorectal cancer risk.
This study investigates the association between SSRI use and decreased colorectal cancer risk, and tricyclic antidepressant use and increased colorectal cancer risk in humans.

Purpose Of The Study

To assess the relationship between selective serotonin reuptake inhibitor (SSRI) use and the risk of developing colorectal cancer.
To evaluate whether tricyclic antidepressant use is associated with an increased risk of colorectal cancer.

Main Methods

A population-based nested case-control study was conducted from 1981 to 2000 in Saskatchewan, Canada.
Data included 6,544 colorectal cancer cases for tricyclic antidepressant analysis and 3,367 cases for SSRI analysis, with four controls matched per case.
Conditional logistic regression was used to analyze incidence-rate ratios, considering antidepressant dose and duration of use.

Main Results

High daily doses of selective serotonin reuptuptake inhibitors (SSRI) (>6.0x10(-6) mol/day) used 0-5 years before diagnosis were associated with a decreased risk of colorectal cancer (IRR 0.70; 95% CI 0.50-0.96).
A significant trend (p=0.0172) supported the reduced risk with increasing SSRI dose.
No consistent association was found between tricyclic antidepressant use and colorectal cancer risk.

Conclusions

Selective serotonin reuptake inhibitor (SSRI) use may exert an antipromoter or direct cytotoxic effect on colorectal tumors.
Further research is recommended to explore confounders like lifestyle, diet, and comorbidities to fully understand the impact on colorectal cancer occurrence.

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