Department of Economics and Business Economics

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

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • A Tønder
  • T Munk-Olsen
  • M Vestergaard
  • J T Larsen
  • N P Suppli, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, Building R, 8210 Aarhus V, Denmark; Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 København Ø, Denmark; Mental Health Centre Copenhagen, Faculty of Health and Medical Science, University of Copenhagen, Bispebjerg Bakke 23A, 2400 København, NV, Denmark. Electronic address: suppli@cancer.dk.
  • ,
  • S O Dalton, Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 København Ø, Denmark. Electronic address: sanne@cancer.dk.
  • ,
  • P Vedsted
  • M Nordentoft, The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, Building R, 8210 Aarhus V, Denmark; Mental Health Centre Copenhagen, Faculty of Health and Medical Science, University of Copenhagen, Bispebjerg Bakke 23A, 2400 København, NV, Denmark. Electronic address: d198080@dadlnet.dk.
  • ,
  • P B Mortensen
  • T M Laursen

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.

Original languageEnglish
JournalSchizophrenia Research
Volume201
Pages (from-to)62-69
Number of pages8
ISSN0920-9964
DOIs
Publication statusPublished - 2018

    Research areas

  • Bipolar affective disorder, CARE, COMORBIDITY, Cancer stage, DANISH, DEPRESSION, Mortality, NATIONWIDE, PEOPLE, RISK, Register-based, SCHIZOPHRENIA, SUICIDE, SURVIVAL, Schizoaffective disorder, Schizophrenia, Follow-Up Studies, Humans, Mental Disorders/mortality, Male, Incidence, Female, Registries, Comorbidity, Neoplasms/diagnosis, Sex Factors, Denmark, Neoplasm Staging

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