Department of Economics and Business Economics

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

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Impact of severe mental illness on cancer stage at diagnosis and subsequent mortality : A population-based register study. / Tønder, A; Munk-Olsen, T; Vestergaard, M; Larsen, J T; Suppli, N P; Dalton, S O; Vedsted, P; Nordentoft, M; Mortensen, P B; Laursen, T M.

In: Schizophrenia Research, Vol. 201, 2018, p. 62-69.

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@article{fd147472deda407c88302c40cc73f484,
title = "Impact of severe mental illness on cancer stage at diagnosis and subsequent mortality: A population-based register study",
abstract = "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.",
keywords = "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",
author = "A T{\o}nder and T Munk-Olsen and M Vestergaard and Larsen, {J T} and Suppli, {N P} and Dalton, {S O} and P Vedsted and M Nordentoft and Mortensen, {P B} and Laursen, {T M}",
note = "Copyright {\textcopyright} 2018 Elsevier B.V. All rights reserved.",
year = "2018",
doi = "10.1016/j.schres.2018.05.011",
language = "English",
volume = "201",
pages = "62--69",
journal = "Schizophrenia Research",
issn = "0920-9964",
publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - Impact of severe mental illness on cancer stage at diagnosis and subsequent mortality

T2 - A population-based register study

AU - Tønder, A

AU - Munk-Olsen, T

AU - Vestergaard, M

AU - Larsen, J T

AU - Suppli, N P

AU - Dalton, S O

AU - Vedsted, P

AU - Nordentoft, M

AU - Mortensen, P B

AU - Laursen, T M

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

KW - Bipolar affective disorder

KW - CARE

KW - COMORBIDITY

KW - Cancer stage

KW - DANISH

KW - DEPRESSION

KW - Mortality

KW - NATIONWIDE

KW - PEOPLE

KW - RISK

KW - Register-based

KW - SCHIZOPHRENIA

KW - SUICIDE

KW - SURVIVAL

KW - Schizoaffective disorder

KW - Schizophrenia

KW - Follow-Up Studies

KW - Humans

KW - Mental Disorders/mortality

KW - Male

KW - Incidence

KW - Female

KW - Registries

KW - Comorbidity

KW - Neoplasms/diagnosis

KW - Sex Factors

KW - Denmark

KW - Neoplasm Staging

UR - http://www.scopus.com/inward/record.url?scp=85048166662&partnerID=8YFLogxK

U2 - 10.1016/j.schres.2018.05.011

DO - 10.1016/j.schres.2018.05.011

M3 - Journal article

C2 - 29891274

VL - 201

SP - 62

EP - 69

JO - Schizophrenia Research

JF - Schizophrenia Research

SN - 0920-9964

ER -