Document Type
Article
Publication Date
4-6-2011
Abstract
Background
Antidepressant (AD) use has been purported to increase the risk of breast and ovarian cancer, although both epidemiological and pre-clinical studies have reported mixed results [1]–[6]. Previous studies in a variety of biomedical fields have found that financial ties to drug companies are associated with favorable study conclusions [7].
Methods and Findings
We searched English-language articles in MEDLINE, PsychINFO, the Science Citations Index and the Cochrane Central Register of Controlled Clinical Trials (through November 2010). A total of 61 articles that assessed the relationship between breast and ovarian cancer and AD use and articles that examined the effect of ADs on cell growth were included. Multi-modal screening techniques were used to investigate researchers' financial ties with industry. A random effects meta-analysis was used to pool the findings from the epidemiological literature. Thirty-three percent (20/61) of the studies reported a positive association between ADs and cancer. Sixty-seven percent (41/61) of the studies reported no association or antiproliferative effect. The pooled odds ratio for the association between AD use and breast/ovarian cancer in the epidemiologic studies was 1.11 (95% CI, 1.03–1.20). Researchers with industry affiliations were significantly less likely than researchers without those ties to conclude that ADs increase the risk of breast or ovarian cancer. (0/15 [0%] vs 20/46 [43.5%] (Fisher's Exact test P = 0.0012).
Conclusions
Both the pre-clinical and clinical data are mixed in terms of showing an association between AD use and breast and ovarian cancer. The possibility that ADs may exhibit a bi-phasic effect, whereby short-term use and/or low dose antidepressants may increase the risk of breast and ovarian cancer, warrants further investigation. Industry affiliations were significantly associated with negative conclusions regarding cancer risk. The findings have implications in light of the 2009 USPSTF guidelines for breast cancer screening and for the informed consent process.
Recommended Citation
Cosgrove L, Shi L, Creasey DE, Anaya-McKivergan M, Myers JA, et al. (2011) Antidepressants and Breast and Ovarian Cancer Risk: A Review of the Literature and Researchers' Financial Associations with Industry. PLoS ONE 6(4): e18210. doi:10.1371/journal.pone.0018210.
Publisher
Public Library of Science (PLoS)
Rights
© 2011 Cosgrove et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Included in
Oncology Commons, Psychiatric and Mental Health Commons, Science and Technology Policy Commons
Comments
Originally published in the open access journal PLoS ONE: http://www.plosone.org.
This study was funded in part by the non-profit cancer foundation “Men with Heart” by a grant awarded to Dr. Cosgrove. She also received two internal grants from the University of Massachusetts-Boston (a proposal development grant and the Endowed Faculty Career Development Award). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.