Haloperidol and other antipsychotics exposure before endometrial cancer diagnosis: a population-based case-control study
Wei-Ling Chen 1, 2, 3, Srinivasan Nithiyanantham 3, Yan-Chiao Mao 2, 4, 5, Chih-Hsin Muo 3, Chih-Pin Chuu 6, Shih-Ping Liu 1, 3, 7, Min-Wei Huang 8, Kuan-Pin Su 1, 3, 9*
1China Medical University, 2Taichung Veterans General Hospital, 3China Medical University Hospital, 4National Defense Medical Center, 5Taipei Veterans General Hospital, 6National Health Research Institute, 7Asia University, 8Taichung Veterans General Hospital, Chiayi, 9An-Nan Hospital, China Medical University, Tainan
Received: April 6, 2021; Revised: May 8, 2021; Accepted: May 17, 2021; Published online: May 17, 2021.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: Endometrial cancer is the most common malignancy of the female genital tract worldwide, and the associated relationship between endometrial cancer formation and various antipsychotics need to be confirmed.
Methods: We conducted a case-control study by using data from Taiwan National Health Insurance Research Database (NHIRD) to compare individual antipsychotic exposure between females with and without endometrial cancer. Among 14,079,089 females in the 12-year population-based national dataset, 9,502 females with endometrial cancer were identified. Their medical records of exposure to antipsychotics, including quetiapine, haloperidol, risperidone, olanzapine, amisulpride, clozapine, and aripiprazole, for up to 3 years before endometrial cancer diagnosis were reviewed. Daily dosage and cumulative exposure days were analyzed in the risky antipsychotic users. Additionally, the subsequent 5-year mortality rate of endometrial cancer among users of the risky antipsychotic were also analyzed.
Results: Among endometrial cancer patients, the proportion of those who have used haloperidol before being diagnosed with endometrial cancer is significantly higher than other antipsychotic users. The significant odds ratio (OR) and a 95% confidence interval of 1.75 (1.31-2.34) were noted. Furthermore, haloperidol users were associated with a significantly higher 5-year mortality rate after getting endometrial cancer than non-users.
Conclusion: There is a high correlation between the use of haloperidol and endometrial cancer formation. However, the underlying pathological biomechanisms require additional investigations.
Keywords: Antipsychotics, Endometrial cancer, Haloperidol, NHIRD


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