Hippisley-Cox Julia, Vinogradova Yana, Coupland Carol, Parker Chris
Division of Primary Care, University of Nottingham, 13th Floor Tower Bldg, University Park, Nottingham NG7 2RD, England.
Arch Gen Psychiatry. 2007 Dec;64(12):1368-76. doi: 10.1001/archpsyc.64.12.1368.
There is conflicting evidence on whether people with schizophrenia have a different risk of cancer from that of the general population.
To determine the risk of 6 common cancers in patients with schizophrenia or bipolar disorder.
Population-based, nested, case-control study.
A total of 454 practices contributing to the QRESEARCH general practice database.
We analyzed 40,441 incident cases of 6 cancers (breast, colon, rectal, gastroesophageal, prostate, and respiratory) and up to 5 controls per case matched by single year of age, sex, general practice, and calendar time.
Odds ratios (ORs) for cancer risk associated with schizophrenia and bipolar disorder, adjusting for smoking, body mass index, socioeconomic status, comorbidities, and prescribed medications, including antipsychotics.
For breast cancer, we identified 10,535/50,074 cases/controls; colon cancer, 5108/24,458; rectal cancer, 3248/15,552; gastroesophageal cancer, 3854/18,477; prostate cancer, 10,190/48,748; and respiratory cancer, 7506/35,981. After adjustment, patients with schizophrenia had a 190% increased colon cancer risk (adjusted OR, 2.90; 95% confidence interval [CI], 1.85-4.57), a marginal increased breast cancer risk (adjusted OR, 1.52; 95% CI, 1.10-2.11), and a 47% decreased respiratory cancer risk (adjusted OR, 0.53, 95% CI, 0.34-0.85). Patients with schizophrenia taking antipsychotics had a 308% increased colon cancer risk (adjusted OR, 4.08; 95% CI, 2.43-6.84). Patients with bipolar disorder had cancer risks similar to patients with neither condition after adjustment.
Patients with schizophrenia have a significantly higher risk of colon cancer and a lower risk of respiratory cancer compared with patients without schizophrenia after adjustment for confounders. In contrast, the risks of cancer in patients with and without bipolar disorder are similar, suggesting that residual confounding is unlikely to explain the findings. The increased risk of colon cancer is particularly marked in patients with schizophrenia who take antipsychotic medications.
关于精神分裂症患者患癌风险是否与普通人群不同，存在相互矛盾的证据。
确定精神分裂症或双相情感障碍患者患6种常见癌症的风险。
基于人群的巢式病例对照研究。
共有454家医疗机构向QRESEARCH全科医疗数据库提供数据。
我们分析了6种癌症（乳腺癌、结肠癌、直肠癌、胃食管癌、前列腺癌和呼吸道癌）的40441例新发病例，每例病例最多匹配5名对照，对照按年龄、性别、全科医疗机构和日历时间进行匹配。
与精神分裂症和双相情感障碍相关的癌症风险比值比（OR），对吸烟、体重指数、社会经济地位、合并症和处方药物（包括抗精神病药物）进行校正。
对于乳腺癌，我们确定了10535/50074例病例/对照；结肠癌，5108/24458；直肠癌，3248/15552；胃食管癌，3854/18477；前列腺癌，10190/48748；呼吸道癌，7506/35981。校正后，精神分裂症患者患结肠癌的风险增加190%（校正OR，2.90；95%置信区间[CI]，1.85 - 4.57），患乳腺癌的风险略有增加（校正OR，1.52；95%CI，1.10 - 2.11）以及患呼吸道癌的风险降低47%（校正OR，0.53，95%CI，0.34 - 0.85）。服用抗精神病药物的精神分裂症患者患结肠癌的风险增加308%（校正OR，4.08；95%CI，2.43 -
