Barak Yoram, Achiron Anat, Mandel Matilda, Mirecki Ilona, Aizenberg Dov
Psychogeriatric Department, Abarbanel Mental Health Center, Bat-Yam, Israel.
Cancer. 2005 Dec 15;104(12):2817-21. doi: 10.1002/cncr.21574.
The incidence of cancer in patients with schizophrenia has been conversely reported to be higher, lower, or similar to that in the general population. The effects of lifestyle factors such as excess smoking, exposure to neuroleptic medications, and genetic factors that may influence the incidence of cancer in this group are not clear. The current study was performed to evaluate the frequency of cancer in a large cohort of patients with schizophrenia and to determine the standardized incidence ratios (SIRs) of any malignancy in this group.
Data regarding the design, setting, and participants of the current study were analyzed from a cohort of 3226 patients with schizophrenia who were enrolled in the computerized health registry of the Abarbanel Mental Health Center between 1993-2003. The mean age of the patients at the time of the diagnosis of cancer was 49 +/- 14.7 years, with the majority of patients (61%) being male. All patients with schizophrenia records in the database were combined with the records of the Israeli National Cancer Registry to identify pathologically confirmed cancer comorbidity. The cancer incidence rates among patients with schizophrenia were compared with the expected incidence in an age-matched and gender-matched general population sample for the same time interval.
Among 1247 female patients with schizophrenia, 22 (1.8%) developed breast cancer and 68 (5.5%) developed cancers of any type. Fifty-two of the 1979 male schizophrenic patients (2.6%) developed cancer. The SIRs were 0.58 (95% confidence interval [95% CI], 0.48-0.69) with a P value of < 0.05 for all cancers in the cohort, and 0.60 (95% CI, 0.37-0.90) for female breast cancer.
The results of the current study demonstrate a reduced risk of cancer in patients with schizophrenia. The mechanisms responsible for the lower risk need be investigated further.
关于精神分裂症患者癌症发生率的报道结果相反，有报道称其高于、低于或与普通人群相似。诸如过度吸烟、接触抗精神病药物等生活方式因素以及可能影响该群体癌症发生率的遗传因素的作用尚不清楚。本研究旨在评估一大群精神分裂症患者的癌症发生频率，并确定该群体中任何恶性肿瘤的标准化发病比（SIR）。
对1993年至2003年间纳入阿巴巴内尔心理健康中心计算机化健康登记系统的3226例精神分裂症患者队列的研究设计、研究地点和参与者数据进行分析。癌症诊断时患者的平均年龄为49±14.7岁，大多数患者（61%）为男性。将数据库中所有精神分裂症患者记录与以色列国家癌症登记处记录相结合，以识别经病理证实的癌症合并症。将精神分裂症患者的癌症发病率与同一时间间隔内年龄和性别匹配普通人群样本的预期发病率进行比较。
在1247例女性精神分裂症患者中，22例（1.8%）患乳腺癌，68例（5.5%）患任何类型癌症。1979例男性精神分裂症患者中有52例（2.6%）患癌症。该队列中所有癌症的标准化发病比为0.58（95%置信区间[95%CI]，0.48 - 0.69），P值<0.05，女性乳腺癌的标准化发病比为0.60（95%CI，0.37 - 0.90）。
本研究结果表明精神分裂症患者患癌风险降低。导致风险降低的机制需要进一步研究。
