TY - JOUR
T1 - Breast cancer risks following antipsychotic use in women with bipolar disorder versus schizophrenia
T2 - A territory-wide nested case-control study spanning two decades
AU - Chu, Rachel Yui Ki
AU - Wei, Yue
AU - Osborn, David P.J.
AU - Ng, Vanessa Wai Sei
AU - Cheng, Franco Wing Tak
AU - Chan, Sherry Kit Wa
AU - Chan, Sandra Sau Man
AU - Wong, Ian Chi Kei
AU - Chan, Esther Wai Yin
AU - Lai, Francisco Tsz Tsun
PY - 2023/8
Y1 - 2023/8
N2 - Accrued epidemiologic data largely support an association of antipsychotic use with breast cancer in women with schizophrenia. No studies have specifically investigated such risks in women with bipolar disorder. This study aims to examine the association between antipsychotics and breast cancer in women with bipolar disorder and compare it against schizophrenia. We conducted a nested case-control study using a territory-wide public healthcare database in Hong Kong examining women aged ≥18 years with bipolar disorder or schizophrenia. Using incidence density sampling, women with a breast cancer diagnosis were matched by up to 10 control participants. In total, 672 case participants (109 with bipolar disorder) and 6,450 control participants (931 with bipolar disorder) were included. Results show a significant association of first-generation antipsychotics with breast cancer in both women with schizophrenia [adjusted odds ratio (aOR) 1.49, 95% confidence interval (CI) 1.17-1.90] or bipolar disorder (aOR 1.80, 95% CI 1.11-2.93). Second-generation antipsychotics was associated with breast cancer only in women with bipolar disorder (aOR 2.49, 95% CI 1.29-4.79), with no significant association found in women with schizophrenia (aOR 1.10, 95% CI 0.88-1.36). In conclusion, further research on breast cancer risks is warranted for women with bipolar disorder on antipsychotics.
AB - Accrued epidemiologic data largely support an association of antipsychotic use with breast cancer in women with schizophrenia. No studies have specifically investigated such risks in women with bipolar disorder. This study aims to examine the association between antipsychotics and breast cancer in women with bipolar disorder and compare it against schizophrenia. We conducted a nested case-control study using a territory-wide public healthcare database in Hong Kong examining women aged ≥18 years with bipolar disorder or schizophrenia. Using incidence density sampling, women with a breast cancer diagnosis were matched by up to 10 control participants. In total, 672 case participants (109 with bipolar disorder) and 6,450 control participants (931 with bipolar disorder) were included. Results show a significant association of first-generation antipsychotics with breast cancer in both women with schizophrenia [adjusted odds ratio (aOR) 1.49, 95% confidence interval (CI) 1.17-1.90] or bipolar disorder (aOR 1.80, 95% CI 1.11-2.93). Second-generation antipsychotics was associated with breast cancer only in women with bipolar disorder (aOR 2.49, 95% CI 1.29-4.79), with no significant association found in women with schizophrenia (aOR 1.10, 95% CI 0.88-1.36). In conclusion, further research on breast cancer risks is warranted for women with bipolar disorder on antipsychotics.
KW - Humans
KW - Female
KW - Adolescent
KW - Adult
KW - Antipsychotic Agents/adverse effects
KW - Bipolar Disorder/drug therapy
KW - Schizophrenia/drug therapy
KW - Case-Control Studies
KW - Breast Neoplasms/drug therapy
UR - https://www.sciencedirect.com/science/article/pii/S0165178123002378
U2 - 10.1016/j.psychres.2023.115287
DO - 10.1016/j.psychres.2023.115287
M3 - Article
C2 - 37320990
SN - 0165-1781
VL - 326
JO - Psychiatry Research
JF - Psychiatry Research
M1 - 115287
ER -