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Excess cancer mortality in psychiatric patients
Stephen Kisely1, Joseph Sadek, Adrian MacKenzie
1Community Care and Epidemiology, School of Medicine, Griffith University, Meadowbrook, Queensland, Australia. s.kisely@griffith.edu.au
Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|December 18, 2008
Summary
Individuals with mental illness experience higher cancer mortality rates, but not always higher incidence. This suggests potential delays in diagnosis or treatment access for this population.
Area of Science:
- Public Health
- Epidemiology
- Psychiatry
Background:
- Conflicting data exists regarding cancer incidence and mortality in psychiatric patients.
- Most studies indicate higher cancer mortality but similar incidence compared to the general population.
Purpose of the Study:
- To investigate the association between mental illness and cancer incidence, first admission rates, and mortality in Nova Scotia.
- To apply a standard methodology to reconcile conflicting previous findings.
Main Methods:
- A population-based record-linkage study was conducted.
- Data from 247,344 patients with mental health service contact (1995-2001) were linked with cancer and death records.
Main Results:
- Cancer mortality was significantly higher in both males (72%) and females (59%) with mental illness.
- Elevated first admission rates mirrored mortality trends.
- Evidence for increased cancer incidence was weaker and inconsistent, with some sites showing no increase compared to the general population.
Conclusions:
- People with mental illness in Nova Scotia exhibit increased cancer mortality, not fully explained by incidence.
- Potential factors include delayed diagnosis, advanced staging at diagnosis, and healthcare access/communication barriers.
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