Article

Impact of severe mental illness on cancer stage at diagnosis and subsequent mortality: A population-based register study

Schizophrenia Research, Elsevier, ISSN 0920-9964

Volume 201, 2018

DOI:10.1016/j.schres.2018.05.011, Dimensions: pub.1104493914, PMID: 29891274,

Authors

Toender, A. * (1) (2)
Munk-Olsen, T. (1) (2)
Larsen, J.T. (1) (2)
Suppli, N.P. (1) (4) (5)
Nordentoft, M. (1) (5)
Mortensen, P.B. (1) (2)
Laursen, T.M. (1) (2)

* Corresponding author

Affiliations

Organisations

  1. (1) Lundbeck Foundation, grid.452548.a
  2. (2) Aarhus University, grid.7048.b, AU
  3. (3) Research Unit for General Practice, Department of Public Health, Aarhus University, Department of Public Health, Bartholins Allé 2, Building 1260, 8000 Aarhus C, Denmark
  4. (4) Danish Cancer Society, grid.417390.8
  5. (5) University of Copenhagen, grid.5254.6, KU

Countries

Denmark

Continents

Europe

Description

BACKGROUND: Excess mortality in individuals with severe mental illness (SMI) is often explained by physical comorbidity and suboptimal healthcare. Cancer is a prevalent cause of death, and tumour stage at diagnosis is a strong predictor of mortality. We aimed to study cancer incidence, disease stage at diagnosis and subsequent mortality in individuals with SMI compared to individuals without SMI. METHODS: The entire Danish population was followed in 1978-2013 using nationwide registries. Cancer incidence and subsequent mortality stratified by disease stage were compared in individuals with and without SMI. Cox regression was used to estimate incidence rate ratios (IRR) and mortality rate ratios (MRR). Cancer was examined overall and grouped by major aetiological factors. RESULTS: The overall cancer incidence rate was lower in males with SMI than in males without SMI; IRR = 0.89 (95% CI: 0.85-0.94), but rates were similar in females with SMI and without SMI; IRR = 1.03 (95% CI: 0.99-1.07). The overall mortality rate was higher in individuals with SMI than those without; MRR = 1.56 (95% CI: 1.48-1.64) for males and MRR = 1.49 (95% CI: 1.43-1.56) for females. Incidence rates and mortality rates showed similar estimates when stratified by tumour stage and aetiology. CONCLUSIONS: We found lower cancer incidence in males with SMI compared to males without SMI and similar incidence in the two groups of women. Higher subsequent mortality was found in both sexes with SMI. The excess mortality was not explained by more advanced stages of cancer; future studies should evaluate the effect of cancer treatment and rehabilitation.

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Main Subject Area

Fields of Research

Sustainable Development Goals

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NORA University Profiles

Aarhus University

University of Copenhagen

Danish Open Access Indicator

2018: Unused

Research area: Social Sciences

Danish Bibliometrics Indicator

2018: Level 1

Research area: Social Sciences

Dimensions Citation Indicators

Times Cited: 7

Field Citation Ratio (FCR): 4.27

Relative Citation ratio (RCR): 1.49