Association between antidepressant medication use and epithelial ovarian cancer risk: a systematic review and meta-analysis of observational studies

Summary

Aim

To clarify the inconsistent findings in the association between antidepressant use and the risk of epithelial ovarian cancer (EOC).

Methods

Meta-analysis of observational studies retrieved from the PubMed, EMBASE, and Web of Science databases prior to August 15, 2017. Two researches independently screened studies and extracted study characteristics and risk estimates. The odds ratios (OR) and 95% confidence intervals (CI) of EOC risk were summarized using an inverse variance weighted random-effects model. Heterogeneity between studies was assessed with the I² statistic.

Results

Eight case-control studies involving 7878 EOC cases and 73,913 controls were identified. Compared with non-use, use of antidepressants was not significantly associated with EOC risk (summarized OR=1.10, 95%CI: 0.91–1.32, I²=74.4%). Similar null results were also observed in the use of selective serotonin reuptake inhibitors (OR=1.04, 95%CI=0.80–1.35), tricyclic antidepressants (OR=1.01, 95%CI=0.79–1.30), and other antidepressant drugs (OR=0.91, 95%CI=0.74–1.12). Subgroup analyses of study characteristics, stratified by the type of control subjects, geographic location, exposure assessment, number of cases, and adjustment for potential confounders, showed that the ORs were broadly consistent across strata. The OR for per 1 year-increment of duration was 0.99 (95%CI=0.94–1.05, I²=40.0%, p=0.154). Additionally, the OR for the greatest intensity of antidepressant use compared with never use was 0.82 (95%CI=0.70–0.98, I²=0%, p=0.489). Furthermore, no evidence of publication bias was detected through Funnel plots as well as Egger's and Begg's tests.

Conclusions

There is no association between antidepressant use and EOC risk. Further prospective studies are warranted to confirm these findings.

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