title: Antidepressants in association with reducing risk of oral cancer occurrence: a nationwide population-based cohort and nested case-control studies.
abstract: OBJECTIVE
  Several studies suggested that antidepressant use may increase or decrease the risk of cancer occurrence, depending on specific cancer types. The possible carcinogenic effect of antidepressants has received substantial attention; however, evidence remains inconclusive. Here we investigated associations between the use of antidepressants and occurrences of oral cancer (OC).
  
  
  METHODS
  Two million samples were randomly collected from the National Health Insurance Research Database in Taiwan, which covers 98% of the total population (23 million). All patients from2000 to 2009 were followed up. We identified 5103 patients newly diagnosed with OC after antidepressants use in addition to 20,412 non-OC matched subjects and 95,452 unmatched non-OC subjects.
  
  
  RESULTS
  In nested case control analysis, factors associating with OC, including age [OR = 1.02; 95% confidence interval (CI) = 1.01-1.03) and male (OR = 5.30; 95% CI = 4.92-5.70) were independently associated with increased risk of OC. Based on the functions of antidepressants, antidepressants treatment medications were further classified to investigate risk of OC. Selective serotonin reuptake inhibitors (OR = 0.61; 95% CI = 0.53-0.70) and tricyclic antidepressants (OR = 0.57; 95% CI = 0.52-0.63) were associated with reduced risk of OC. The risk of developing OC among subjects taking antidepressants was less than 26% [hazard ratio (HR) =0.74; 95% CI = 0.68-0.81] in prospective cohort study. The effect of a cumulative duration and dose was a significantly reduced risk of OC.
  
  
  CONCLUSIONS
  The association between antidepressant use and decreasing OC risk were demonstrated by both prospective and nested case-control studies.
authors: Environment-Omics-Disease Research Center, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
authors: Chia-Min
authors: CM
authors: Chung
authors: Environment-Omics-Disease Research Center, China Medical University Hospital, Taichung, Taiwan.
authors: Tzer-Min
authors: TM
authors: Kuo
authors: Environment-Omics-Disease Research Center, China Medical University Hospital, Taichung, Taiwan.|Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan.
authors: Shang-Lun
authors: SL
authors: Chiang
authors: Environment-Omics-Disease Research Center, China Medical University Hospital, Taichung, Taiwan.
authors: Zhi-Hong
authors: ZH
authors: Wang
authors: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.|Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan.
authors: Chung-Chieh
authors: CC
authors: Hung
authors: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.|Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan.
authors: Hsien-Yuan
authors: HY
authors: Lane
authors: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
authors: Chiu-Shong
authors: CS
authors: Liu
authors: Environment-Omics-Disease Research Center, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
authors: Ying-Chin
authors: YC
authors: Ko
mesh_terms: D000928:Antidepressive Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents
keywords: antidepressants; cohort; oral cancer