Key clinical point: Collaboration is needed between psychiatrists, oncologists, and other multidisciplinary team members to provide quality care for cancer patients with schizophrenia.
Major finding: Mortality risk from breast, lung, and colon cancer is higher for people with schizophrenia, compared with the general population or controls. However, such risks from prostate cancer for men with schizophrenia were not found.
Study details: The data come from a systematic review and meta-analysis of seven studies consisting of 1,162,971 participants with schizophrenia. For breast cancer, the pooled relative risk was 1.97 (95% confidence interval, 1.38-2.83; P less than 0.001); 1.93 for lung cancer (95% CI, 1.46-2.54; P less than 0.001), and 1.69 for colon cancer (95% CI, 1.60-1.80; P less than 0.001). For prostate cancer, the mortality risk was higher among male patients with schizophrenia, but the risk did not reach statistical significance (pooled relative risk, 1.58; 95% CI, 0.79-3.15; P = 0.195).
Disclosures: The study was funded by grants from entities tied to Soochow University in Jiangsu, China. The authors reported no disclosures.
Ni L et al. BMC Psychiatry. 2019. doi: 10.1186/s12888-019-2332-z.
Individuals with schizophrenia, lose an average of 1-2 decades of life compared to the general population with most of the excess risk attributed to poor medical care, unhealthy lifestyle factors, the side effects of antipsychotic medications and death from suicide. This report underscores the elevated risk from specific type of cancers, namely those of the breast, lung and colon. The implication of findings is that effective screening (for breast and colon cancer) and clinical evaluation (family history, personal smoking history) need to be critical components of clinical care for people with serious mental illness. Integrating mental and physical healthcare delivery may help to reverse the unacceptability high premature mortality risk among those with schizophrenia.—Martha Sajatovic, MD, Professor of Psychiatry and of Neurology; Willard Brown Chair in Neurological Outcomes Research; Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center; Case Western Reserve University School of Medicine.