Cancer-related mortality among individuals with schizophrenia: systematic review and meta-analysis of cohort studies.

Abstract

Background: Individuals with schizophrenia have shown distinct cancer incidence patterns.

Aims: We aimed to assess whether their cancer-related mortality differs from the general population overall, by gender and by specific cancer types.

Method: We systematically searched Scopus, Web of Science, PsycINFO, PubMed and Embase, up to December 2025. Each record was independently screened by two reviewers, and data were independently extracted by two investigators. Two authors assessed the quality of the included articles with the Newcastle-Ottawa Scale. Analyses were conducted using Stata version 16; between-study heterogeneity was evaluated with Cochran's Q-statistic and the I²-statistic, and potential sources of heterogeneity were further examined through exploratory meta-regression.

Results: Meta-analysis of cohort studies showed that individuals with schizophrenia had a 55% higher risk of cancer-related death than the general population (standardised mortality ratio (SMR) 1.55; 95% CI 1.16-2.07). In gender-stratified analyses, SMRs for all cancers combined were 1.37 (95% CI 1.01-1.87) in men and 1.43 (95% CI 1.15-1.79) in women. Site-specific SMRs were 1.77 (95% CI 1.17-2.68) for breast, 2.40 (95% CI 2.35-2.45) for respiratory, 1.54 (95% CI 1.35-1.76) for gastrointestinal, 2.32 (95% CI 0.72-7.45) for haematologic, 4.43 (95% CI 0.71-27.62) for skin and soft tissue, 3.03 (95% CI 1.96-4.69) for urogenital and 1.01 (95% CI: 0.36-2.83) for other cancers, although precision varied considerably across cancer sites.

Conclusions: Schizophrenia was associated with substantially elevated cancer-related mortality compared with the general population. These findings underscore the need for earlier cancer detection and guideline-concordant, integrated physical and mental healthcare for this high-risk group.