SSRIs associated with decreased risk of hepatocellular carcinoma: A population-based case-control study

Hsiang-Lin Chan; Wei-Che Chiu; Vincent Chin-Hung Chen; Kuo-You Huang; Tsu-Nai Wang; Yena Lee; Roger S McIntyre; Tsai-Ching Hsu; Charles Tzu-Chi Lee; Bor-Show Tzang

doi:10.1002/pon.4493

SSRIs associated with decreased risk of hepatocellular carcinoma: A population-based case-control study

Psychooncology. 2018 Jan;27(1):187-192. doi: 10.1002/pon.4493. Epub 2017 Aug 8.

Authors

Hsiang-Lin Chan^{1

2}, Wei-Che Chiu^{3

4}, Vincent Chin-Hung Chen^{1

5}, Kuo-You Huang⁶, Tsu-Nai Wang⁷, Yena Lee⁸, Roger S McIntyre^{8

9}, Tsai-Ching Hsu^{10

11

12}, Charles Tzu-Chi Lee¹³, Bor-Show Tzang^{10

11

12

14}

Affiliations

¹ Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan.
² Department of Child Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
³ Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan.
⁴ School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
⁵ Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
⁶ Department of Speech, Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan.
⁷ Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁸ Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada.
⁹ Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada.
¹⁰ Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan.
¹¹ Immunology Research Center, Chung Shan Medical University, Taichung, Taiwan, ROC.
¹² Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan.
¹³ Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan.
¹⁴ Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

PMID: 28666060
DOI: 10.1002/pon.4493

Abstract

Background: Hepatocellular carcinoma (HCC) is the second leading cancer-related cause of mortality worldwide. Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), are commonly used worldwide. Available evidence investigating the association between SSRIs use and HCC risk is limited.

Objective: The present study aimed to investigate if the effect of all kinds of SSRIs on HCC was the same or not using population-based study.

Methods: The nationwide population-based study herein using Taiwan's National Health Insurance Research Database included a total of 59 859 cases with HCC and 285 124 matched controls. Conditional logistic regression analyses were adjusted for confounding variables.

Results: All common kinds of SSRIs including fluoxetine, sertraline, paroxetine, citalopram, escitalopram, and fluvoxamine were associated with lower HCC risk, and the findings were dose-dependent (eg, fluoxetine: 1-28 DDD [defined daily dose]: adjusted odds ratio [aOR]: 0.81, 95% confidence interval [CI], 0.73-0.89; 29-365 DDD: aOR: 0.71, 95% CI, 0.64-0.79; and ≥366 DDD: aOR: 0.55, 95% CI, 0.45-0.67) (P for trend < .001).

Conclusions: All kinds of SSRIs were associated with decreased risk of HCC.

Keywords: SSRIs; Taiwan national insurance; antidepressants; fluoxetine; hepatocellular carcinoma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antidepressive Agents / administration & dosage
Antidepressive Agents / adverse effects*
Carcinoma, Hepatocellular / chemically induced*
Carcinoma, Hepatocellular / diagnosis
Carcinoma, Hepatocellular / epidemiology
Case-Control Studies
Databases, Factual
Female
Humans
Liver Neoplasms / chemically induced*
Liver Neoplasms / diagnosis
Liver Neoplasms / epidemiology
Male
Middle Aged
Odds Ratio
Selective Serotonin Reuptake Inhibitors / administration & dosage
Selective Serotonin Reuptake Inhibitors / adverse effects*
Taiwan / epidemiology

Substances

Antidepressive Agents
Serotonin Uptake Inhibitors