A meta-analysis incorporating tens of thousands of individuals found no association between the use of antidepressants and the risk of epithelial ovarian cancer (EOC).
“The concerns raised by a number of simulated epidemiologic investigations have questioned the possible association between antidepressant use and various types of cancer, including EOC,” wrote study authors led by Yun-Long Huo, MD, of the Shengjing Hospital of China Medical University in Shenyang. Epidemiological evidence has been inconsistent, and other recent analyses have had conflicting findings as well. The new meta-analysis aimed to reconcile some of those earlier reports and determine any potential risk of EOC associated with antidepressant use.
The analysis included a total of 8 published studies, incorporating 7,878 cases of EOC and 73,913 controls. All were published between 1984 and 2017 and used a case-control design, and were conducted in North America, Europe, and Asia. The results were published in the British Journal of Clinical Pharmacology.
The pooled odds ratio (OR) for ever antidepressant use and EOC risk was 1.10 (95% CI, 0.91–1.32). The same was true specifically for selective serotonin reuptake inhibitors, with an OR of 1.04 (95% CI, 0.80–1.35), and for tricyclics, with an OR of 1.01 (95% CI, 0.79–1.30). When the studies that were most heterogeneous were sequentially excluded, the OR further approached 1.00.
Six of the studies, including 7,165 cases and 71,644 controls, allowed for risk estimates, with the longest duration of antidepressant use compared with never-use. The pooled OR for EOC in these studies was 0.89 (95% CI, 0.66–1.19), with low heterogeneity among the studies. Another analysis of the intensity of antidepressant use and EOC risk again found no significant association.
The authors noted that the analysis is limited by the case-control nature of the included studies, though no recent prospective studies have evaluated the issue. Also, they could not rule out the possibility that depression itself could influence the risk of EOC rather than the use of antidepressants. “Considering that severely depressed patients are more likely to be treated with antidepressants, they might just be a surrogate marker for the depression-related incidence of EOC,” they wrote.
It was also not possible to adjust for all potential confounders, such as nulliparity and infertility, which could be associated with both EOC and antidepressant use.
Still, they wrote that “the results of the present updated meta-analysis involving the largest sample size to date…showed no association between antidepressant use and the risk of EOC.”