eprintid: 10153056
rev_number: 7
eprint_status: archive
userid: 699
dir: disk0/10/15/30/56
datestamp: 2022-08-02 14:20:16
lastmod: 2022-08-02 14:20:16
status_changed: 2022-08-02 14:20:16
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Launders, N
creators_name: Scolamiero, L
creators_name: Osborn, DPJ
creators_name: Hayes, JF
title: Cancer rates and mortality in people with severe mental illness: Further evidence of lack of parity
ispublished: pub
divisions: C07
divisions: FH7
divisions: B02
divisions: UCL
divisions: D79
keywords: Bipolar disorder, Psychosis, Schizophrenia, Severe mental illness, cancer
note: Copyright © 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
abstract: Background: Severe mental illness (SMI) is associated with poorer physical health, however the relationship between SMI and cancer is complex and previous study findings are inconsistent. Low incidence of cancer in those with SMI has been attributed to premature mortality, though evidence for this is lacking. We aimed to investigate the relationship between SMI and cancer incidence and mortality, and to assess the effect of premature mortality on cancer incidence rates. / Methods: In this UK-wide matched cohort study using primary care records we calculated incidence and mortality rates of all-cancer, and bowel, lung, breast or prostate cancer, in patients with SMI, compared to matched patients without SMI. We used competing risks regression to account for mortality from other causes. / Findings: 69,632 patients had an SMI diagnosis. The rate of all-cancer diagnoses was reduced in those with SMI (Hazard ratio (HR):0·95; 95%CI 0·93–0·98) compared to those without SMI, and particularly in those with schizophrenia (HR:0·82; 95%CI 0·77–0·88) compared to those without SMI. When accounting for the competing risk of premature mortality, incidence remained lower only in patients with schizophrenia. All-cause mortality after cancer was increased in the SMI group, and cancer-specific mortality was increased in those with schizophrenia (hazard ratio: 1.96; 95%CI 1.57–2.44). / Interpretation: Patients with schizophrenia have lower rates of cancer diagnosis but higher all-cause and cancer-specific mortality rates following diagnosis compared to those without SMI. Premature mortality does not explain these differences, suggesting the findings reflect barriers to cancer diagnosis and treatment, which need to be identified and addressed.
date: 2022-08
date_type: published
publisher: Elsevier BV
official_url: https://doi.org/10.1016/j.schres.2022.07.008
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1967692
doi: 10.1016/j.schres.2022.07.008
medium: Print-Electronic
pii: S0920-9964(22)00280-8
lyricists_name: Osborn, David
lyricists_name: Launders, Naomi
lyricists_name: Hayes, Joseph
lyricists_id: DPJOS02
lyricists_id: NJLAU54
lyricists_id: JFHAY18
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: Schizophrenia Research
volume: 246
pagerange: 260-267
event_location: Netherlands
issn: 0920-9964
citation:        Launders, N;    Scolamiero, L;    Osborn, DPJ;    Hayes, JF;      (2022)    Cancer rates and mortality in people with severe mental illness: Further evidence of lack of parity.                   Schizophrenia Research , 246    pp. 260-267.    10.1016/j.schres.2022.07.008 <https://doi.org/10.1016/j.schres.2022.07.008>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10153056/1/1-s2.0-S0920996422002808-main.pdf