Unfavorable cancer mortality-to-incidence ratios in patients with schizophrenia: A nationwide cohort study in Taiwan, 2000–2019

IF 5.3 2区医学 Q1 PSYCHIATRY

Acta Psychiatrica Scandinavica Pub Date : 2023-08-21 DOI:10.1111/acps.13604

Chu-Syuan Cheng, Wen-Yin Chen, Hu-Ming Chang, Chun-Hung Pan, Sheng-Siang Su, Shang-Ying Tsai, Chiao-Chicy Chen, Chian-Jue Kuo

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引用次数: 0

Abstract

Objectives

Studies on cancer incidence and mortality in patients with schizophrenia have reported inconsistent findings. In this study, we simultaneously investigated cancer incidence and mortality in patients with schizophrenia and evaluated the cancer mortality-to-incidence ratio (MIR), which is rare in the literature.

Methods

From the Taiwan National Health Insurance Database, we collected the data of 107,489 patients who received a diagnosis of schizophrenia between 2000 and 2019. Data regarding cancer incidence and mortality were obtained from the Taiwan Cancer Registry and National Mortality Database, respectively. In total, 3881 incident cancer cases and 2288 cancer mortality cases were identified. Standardized incidence ratios (SIRs), mortality rate ratios (MRRs), and MIRs were compared between patients with schizophrenia and the general population.

Results

The overall rate of cancer incidence was slightly lower (SIR: 0.95; 95% confidence interval [CI]: 0.92–0.98; p < 0.001) and that of cancer mortality was higher (MRR: 1.29; 95% CI: 1.23–1.3; p < 0.001) in patients with schizophrenia than in the general population. The MIR for overall cancer was significantly higher in the patients with schizophrenia. The relative MIR (MIR of patients with schizophrenia divided by that of the general population) was 1.36 (95% CI: 1.30–1.42).

Conclusion

The MIR was significantly higher in the patients with schizophrenia than in the general population, indicating the possible presence of healthcare disparities. Additional studies are required to investigate the potential association between the significantly higher MIR in patients with schizophrenia and healthcare disparities.

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精神分裂症患者的癌症死亡率与发病率:台湾2000-2019年的一项全国性队列研究

目的对精神分裂症患者癌症发病率和死亡率的研究报告了不一致的结果。在本研究中，我们同时调查了精神分裂症患者的癌症发病率和死亡率，并评估了文献中罕见的癌症死亡率与发病率比(MIR)。方法从台湾国民健康保险数据库中收集2000年至2019年期间被诊断为精神分裂症的107,489例患者的数据。癌症发病率和死亡率数据分别来自台湾癌症登记处和国家死亡率数据库。共发现3881例癌症病例和2288例癌症死亡病例。将精神分裂症患者与一般人群的标准化发病率比(SIRs)、死亡率比(MRRs)和MIRs进行比较。结果两组肿瘤总发病率略低(SIR: 0.95;95%置信区间[CI]: 0.92-0.98;p < 0.001)，癌症死亡率更高(MRR: 1.29;95% ci: 1.23-1.3;P < 0.001)。精神分裂症患者总体癌症的MIR明显更高。相对MIR(精神分裂症患者的MIR除以一般人群的MIR)为1.36 (95% CI: 1.30-1.42)。结论精神分裂症患者MIR明显高于普通人群，可能存在医疗保健差异。需要进一步的研究来调查精神分裂症患者显著较高的MIR与医疗保健差异之间的潜在关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.