Antipsychotic use is inversely associated with gastric cancer risk: A nationwide population-based nested case-control study

Cancer Med. 2019 Aug;8(9):4484-4496. doi: 10.1002/cam4.2329. Epub 2019 Jun 10.

Abstract

Objective: The association between antipsychotic use and gastric cancer risk remains unclear. Therefore, this study aimed to determine the association between antipsychotic exposure and the incidence of gastric cancer.

Methods: Using a nested case-control design, a total of 34 470 gastric cancer patients and 163 430 nongastric cancer controls were identified from Taiwan's National Health Insurance Research Database between 1 January 1997 and 31 December 2013. We analyzed the data using a conditional logistic regression model to adjust for possible confounding variables.

Results: Antipsychotic use was independently inversely associated with gastric cancer risk after controlling for potential confounding factors including income, urbanization, medications, physical and medical illness, aspirin use, nonsteroidal anti-inflammatory drug use and triple therapy. In addition, dose-dependent trends against gastric cancer risk were also shown with individual antipsychotic compounds including thioridazine, haloperidol, sulpiride, clozapine, olanzapine, quetiapine, amisulpride, and risperidone. A sensitivity analysis showed that second-generation antipsychotics had significant dose-dependent effects in reducing the risk of gastric cancer risk in patients with and without peptic ulcer disease.

Conclusions: Antipsychotic use was inversely associated with gastric cancer risk, and dose-dependent effects against gastric cancer were also seen with several individual antipsychotic compounds.

Keywords: cancer risk factors; clinical cancer research; digestive cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antipsychotic Agents / therapeutic use*
  • Case-Control Studies
  • Databases, Factual
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Stomach Neoplasms / epidemiology*
  • Taiwan / epidemiology
  • Young Adult

Substances

  • Antipsychotic Agents