Excess Cancer Mortality in Psychiatric Patients

Kisely, Stephen, Sadek, Joseph, MacKenzie, Adrian, Lawrence, David and Campbell, Leslie Anne (2008) Excess Cancer Mortality in Psychiatric Patients. Canadian Journal of Psychiatry, 53 11: 753-761.

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Author Kisely, Stephen
Sadek, Joseph
MacKenzie, Adrian
Lawrence, David
Campbell, Leslie Anne
Title Excess Cancer Mortality in Psychiatric Patients
Journal name Canadian Journal of Psychiatry   Check publisher's open access policy
ISSN 0706-7437
1497-0015
Publication date 2008-11
Year available 2008
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 53
Issue 11
Start page 753
End page 761
Total pages 9
Place of publication Ottawa, Canada
Publisher Canadian Psychiatric Association
Language eng
Subject 111202 Cancer Diagnosis
111708 Health and Community Services
111712 Health Promotion
111714 Mental Health
1199 Other Medical and Health Sciences
Formatted abstract
Objectives: There are conflicting data on cancer incidence and mortality in psychiatric
patients, although most studies suggest that while cancer mortality is higher, incidence is
no different from that in the general population. Different methodologies and outcomes
may account for some of the conflicting results. We investigated the association between
mental illness and cancer incidence, first admission rates, and mortality in Nova Scotia
using a standard methodology.
Method: A population-based record-linkage study of 247 344 patients in contact with
primary care or specialist mental health services during 1995 to 2001 was used. Records
were linked with cancer registrations and death records.
Results: Cancer mortality was 72% higher in males (95%CI, 63% to 82%) and 59% higher
in females (95%CI, 49% to 69%) among patients in contact with mental health services.
This was reflected in similarly elevated first admission rates. However, there was weaker
and less consistent evidence for increased incidence. For several cancer sites, incidence
rate ratios were lower than might be expected given the mortality and first admission rate
ratios, and no higher than that of the general population. These were melanoma, prostate,
bladder, and colorectal cancers in males.
Conclusion: People with mental illness in Nova Scotia have increased mortality from
cancer, which cannot always be explained by increased incidence. Possible explanations
for further study include delays in detection or initial presentation leading to more
advanced staging at diagnosis, and difficulties in communication or access to health care.
Keyword psychiatric disorder
cancer incidence
mortality
Schizophrenic-patients
Breast-cancer
Record-linkage
Risk
Survival
Radiotherapy
Depression
malignancy
Ontario
Smoking
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Wed, 18 Nov 2009, 12:20:54 EST