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The effects of tricyclic antidepressants on breast cancer risk

Abstract

To test the hypothesis that tricyclic antidepressant use increases invasive female breast cancer incidence, we carried out a case–control study within the population of female beneficiaries of the Saskatchewan Prescription Drug Plan aged 35 years from 1981–1995 with no history of cancer since 1970. This agency has provided full or partial coverage for outpatient prescriptions to Saskatchewan residents since 1975. We accrued 5882 histologically proven cases and 23 517 controls, randomly selected from the source population and individually matched on age and sampling time. Heavy exposure to any tricyclic antidepressants was associated with an elevated rate ratio for breast cancer 11–15 years later (2.02, 95% confidence interval: 1.34–3.04). Post hoc analyses based on the results of genotoxicity studies carried out using Drosophila melanogaster suggested that the increased risk could be attributed to the use of the six genotoxic tricyclic antidepressants, and not to the use of the four nongenotoxic tricyclic antidepressants. However, our results may have been confounded by the effects of other determinants of breast cancer associated with tricyclic antidepressant use.

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Acknowledgements

The study was funded by a grant (No. 007312) from the Canadian Breast Cancer Research Initiative. Dr CR Sharpe was supported by a postdoctoral fellowship from the Canadian Institutes of Health Research during part of the work and Dr JP Collet was supported by a grant from the Fonds de la Recherche en Santé du Québec. The study was based in part on data provided by the Saskatchewan Department of Health. The interpretation and conclusions contained in this report do not necessarily represent those of the Government of Saskatchewan or the Saskatchewan Department of Health. The study was also based on data provided by the Saskatchewan Cancer Agency, which bears no responsibility for the analysis of the data or the interpretation of the results.

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Sharpe, C., Collet, JP., Belzile, E. et al. The effects of tricyclic antidepressants on breast cancer risk. Br J Cancer 86, 92–97 (2002). https://doi.org/10.1038/sj.bjc.6600013

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