Post-diagnostic antipsychotic use and cancer mortality: a population based cohort study

Hicks, Blánaid M.; Busby, John; Mills, Ken; O’Neil, Francis A.; McIntosh, Stuart A.; Zhang, Shu-Dong; Liberante, Fabio Giuseppe; Cardwell, Chris R.

doi:10.1186/s12885-020-07320-3

BMC Cancer

Table 3 Crude and adjusted hazard ratios for the association between the use of antipsychotics and breast cancer-specific mortality in patients with severe mental illness

From: Post-diagnostic antipsychotic use and cancer mortality: a population based cohort study

	Users			Non-Users			Unadjusted HR (95% CI)	Adjusted^a HR (95% CI)
	N	Person years	Cancer deaths	N	Person years	Cancer deaths	Unadjusted HR (95% CI)	Adjusted^a HR (95% CI)
All antipsychotics	188	898	25	146	658	23	0.97 (0.54–1.74)	1.11 (0.58–2.14)
1–182 DDDs v non-user	79	382	14	146	658	23	1.11 (0.57, 2.17)	1.37 (0.65, 2.88)
182+ DDDs v non-user	109	516	11	146	658	23	0.82 (0.39, 1.74)	0.87 (0.38, 1.98)
1st generation antipsychotics	97	511	11	237	1044	37	0.75 (0.38–1.50)	0.95 (0.44–2.04)
1–182 DDDs v non-user	47	234	6	237	1044	37	0.81 (0.34, 1.92)	0.99 (0.38, 2.58)
182+ DDDs v non-user	50	277	5	237	1044	37	0.69 (0.27, 1.81)	0.90 (0.31, 2.58)
2nd generation antipsychotics	130	565	16	204	991	32	1.08 (0.59–1.99)	1.10 (0.55–2.18)
1–182 DDDs v non-user	60	288	10	204	991	32	1.24 (0.61, 2.55)	1.44 (0.67, 3.09)
182+ DDDs v non-user	70	276	6	204	991	32	0.88 (0.36, 2.14)	0.72 (0.27, 1.93)
1st generation antipsychotics only	58	333	9	146	658	23	0.87 (0.40, 1.90)	1.07 (0.45, 2.56)
2nd generation antipsychotics only	91	387	14	146	658	23	1.16 (0.59, 2.27)	1.20 (0.55, 2.61)
1st and 2nd generation use	39	178	2	146	658	23	0.56 (0.13, 2.51)	0.80 (0.17, 3.79)
Prolactin elevating antipsychotics^b	131	681	15	203	875	33	0.73 (0.39–1.36)	0.86 (0.44–1.68)
1–182 DDDs v non-user	80	395	10	203	875	33	0.77 (0.38, 1.57)	0.87 (0.40, 1.89)
182+ DDDs v non-user	51	286	5	203	875	33	0.65 (0.25, 1.73)	0.83 (0.29, 2.40)
Prolactin non-elevating antipsychotics^c	101	417	13	233	1138	35	1.30 (0.68–2.49)	1.19 (0.58–2.44)
1–182 DDDs v non-user	32	143	7	233	1138	35	2.00 (0.88, 4.55)	2.00 (0.85, 4.69)
182+ DDDs v non-user	69	275	6	233	1138	35	0.92 (0.38, 2.22)	0.73 (0.28, 1.93)

^aModel contains age, year of diagnosis, treatment within 6 months (separate variables for radiootherapy, chemotherapty, surgery, tamoxifen and aromatase inhibitor use), comorbidities (prior to diagnosis including chronic pulmonary disease, diabetes, renal disease, cerebrovascular disease, peripheral vascular disease, myocardial infarction, peptic ulcer disease and liver disease), hormonal medication use (oral contraceptive and hormone replacement therapy, prior to diagnosis), other medication use (statin and aspirin as time varying covariates) and deprivation (in fifths)
^bProlactin elevating antipsychotics included chlorpromazine,flupentixol,fluphenazine, haloperidol, pericyazine, perphenazine, pimozide, pipotiazine, promazine, trifluoperazine, zuclopenthixol, amisulpride, risperidone and sulpiride
^cProlactin non-elevating antipsychotics included aripiprazole, olanzapine, quetiapine and sertindole

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ISSN: 1471-2407

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