Antidepressant medication use and nasopharyngeal cancer risk: a nationwide population-based study

Figures & data

Table 1 Demographic data of cases and controls

	Cases		Controls		P-value
	(n=16,957)		(n=83,231)
Age (years)					0.99
≤40	5,566	32.82%	27,196	32.68%
41–50	5,311	31.32%	26,148	31.42%
51–60	3,099	18.28%	15,298	18.38%
61–70	2,104	12.41%	10,317	12.40%
71–80	808	4.76%	3,932	4.72%
≥80	69	0.41%	340	0.41%
Sex, female	4,563	26.91%	22,475	27.00%	0.80
Income (NTD)a					<0.0001
0	2,167	12.78%	10,382	12.47%
1–25,000	2,859	16.86%	14,025	16.85%
25,001–40,000	7,515	44.32%	35,063	42.13%
≥40,001	4,416	26.04%	23,761	28.55%
Urbanizationb					<0.0001
Very high	4,797	28.29%	25,289	30.38%
High	8,162	48.14%	39,601	47.59%
Moderate	2,752	16.23%	12,690	15.25%
Low	1,246	7.35%	5,650	6.79%

Notes:

a 1US $=32.3 NTD in year 2008.

b Quartiles by human development index.

Abbreviation: NTD, New Taiwan Dollars.

Table 2 Medical diseases and drugs used with cases and controls

	Cases (n=16,957)		Controls (n=83,231)		P-value
Medical diseases
Depressive disorders	339	2.00%	1,669	2.01%	0.96
T2DM	1,252	7.38%	6,007	7.22%	0.45
Hypertension	2,426	14.31%	10,030	12.05%	<0.0001
Hypercholesterolemia	1,141	6.73%	5,692	6.84%	0.60
EBV infection	0	0%	2	0%	0.52
Alcohol-related disorders and diseases	63	0.37%	309	0.37%	0.99
COPD	1,271	7.50%	5,575	6.70%	0.0002
Tobacco use disorder	26	0.15%	108	0.13%	0.44
Medications
Metformin	696	4.10%	3,376	4.06%	0.77

Abbreviations: EBV, Epstein–Barr virus; T2DM, type 2 diabetes mellitus.

Table 3 Associations of antidepressants use and nasopharyngeal cancer

Antidepressants	Cases (n=16,957)		Controls (n=83,231)		OR
	N	%	N	%	Crude (95% CI)	Adjusteda (95% CI)
SSRIs
≥28 DDD	269	1.59	1,388	1.67	0.94 (0.83–1.07)	0.94 (0.81–1.09)
≥84 DDD	159	0.94	819	0.98	0.94 (0.79–1.12)	0.94 (0.78–1.14)
≥168 DDD	118	0.70	561	0.67	1.02 (0.84–1.25)	1.05 (0.84–1.30)
≥336 DDD	79	0.47	339	0.41	1.13 (0.88–1.45)	1.18 (0.90–1.53)
SNRIs
≥28 DDD	24	0.14	120	0.14	0.97 (0.62–1.50)	0.98 (0.62–1.53)
≥84 DDD	17	0.10	81	0.10	1.01 (0.60–1.70)	1.02 (0.60–1.73)
≥168 DDD	12	0.07	56	0.07	1.02 (0.54–1.90)	1.03 (0.55–1.95)
≥336 DDD	6	0.04	38	0.05	0.75 (0.32–1.78)	0.76 (0.32–1.80)
TCAs
≥28 DDD	288	1.70	1,372	1.65	1.02 (0.90–1.16)	1.02 (0.89–1.17)
≥84 DDD	113	0.67	627	0.75	0.86 (0.71–1.06)	0.86 (0.70–1.05)
≥168 DDD	63	0.37	310	0.37	0.97 (0.74–1.28)	0.97 (0.74–1.28)
≥336 DDD	32	0.19	128	0.15	1.18 (0.80–1.74)	1.18 (0.80–1.74)
RIMAs
≥28 DDD	49	0.29	315	0.38	0.76 (0.56–1.02)	0.75 (0.55–1.03)
≥84 DDD	24	0.14	157	0.19	0.74 (0.48–1.14)	0.74 (0.48–1.15)
≥168 DDD	14	0.08	95	0.11	0.71 (0.41–1.25)	0.72 (0.41–1.27)
≥336 DDD	4	0.02	45	0.05	0.42 (0.15–1.18)	0.43 (0.15–1.19)
NaSSA
≥28 DDD	10	0.06	46	0.06	1.02 (0.51–2.02)	1.03 (0.51–2.06)
≥84 DDD	8	0.05	20	0.02	1.85 (0.81–4.20)	1.90 (0.83–4.35)
≥168 DDD	6	0.04	14	0.02	1.97 (0.76–5.13)	2.00 (0.76–5.24)
≥336 DDD	2	0.01	4	0.00	2.41 (0.44–13.2)	2.42 (0.44–13.3)
SARI
≥28 DDD	110	0.65	560	0.67	0.96 (0.78–1.17)	0.96 (0.77–1.19)
≥84 DDD	45	0.27	253	0.30	0.86 (0.63–1.19)	0.87 (0.63–1.20)
≥168 DDD	16	0.09	115	0.14	0.68 (0.40–1.14)	0.67 (0.40–1.14)
≥336 DDD	5	0.03	45	0.05	0.53 (0.21–1.34)	0.53 (0.21–1.34)
NDRI
≥28 DDD	5	0.03	28	0.03	0.86 (0.33–2.22)	0.85 (0.33–2.21)
≥84 DDD	2	0.01	17	0.02	0.55 (0.13–2.42)	0.55 (0.13–2.41)
≥168 DDD	2	0.01	6	0.01	1.62 (0.33–8.03)	1.69 (0.34–8.40)
≥336 DDD	2	0.01	2	0.00	4.73 (0.67–33.6)	4.97 (0.70–35.4)

Note:

a Adjusting with age, urbanization, income, depressive disorders, T2DM, hypertension, hypercholesterolemia, EBV infection, alcohol-related disorders, tobacco use disorder, and metformin.

Abbreviations: DDD, defined daily dose; EBV, Epstein–Barr virus; NaSSA, noradrenergic and specific serotonergic antidepressant; NDRI, norepinephrine–dopamine reuptake inhibitor; OR, odds ratio; RIMAs, reversible monoamine oxidase inhibitors; SARI, serotonin antagonist and reuptake inhibitor; SNRIs, serotonin–norepinephrine reuptake inhibitors; SSRIs, selective serotonin reuptake inhibitors; T2DM, type 2 diabetes mellitus; TCAs, tricyclic antidepressants.