Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK.
Lancet Oncol. 2010 Aug;11(8):797-804. doi: 10.1016/S1470-2045(10)70085-1. Epub 2010 Jul 3.
There has been increasing recognition of the high physical morbidity in patients with severe mental illness, but little has been written about cancer in these patients. Therefore, we review the published work on risk of cancer in patients with severe mental illness, treatment challenges, and ethical issues. Severe mental illness is associated with behaviours that predispose an individual to an increased risk of some cancers, including lung and breast cancer, although lower rates of other cancers are reported in this population. Severe mental illness is also associated with disparities in screening for cancer and with higher case-fatality rates. This higher rate is partly due to the specific challenges of treating these patients, including medical comorbidity, drug interactions, lack of capacity, and difficulties in coping with the treatment regimen as a result of psychiatric symptoms. To ensure that patients with severe mental illness receive effective treatment, inequalities in care need to be addressed by all health-care professionals involved, including those from mental health services and the surgical and oncology teams.
人们越来越认识到严重精神疾病患者身体发病率高，但关于这些患者的癌症却鲜有报道。因此，我们回顾了已发表的关于严重精神疾病患者癌症风险、治疗挑战和伦理问题的文献。严重精神疾病与某些癌症（包括肺癌和乳腺癌）的易患行为有关，但该人群的其他癌症发病率较低。严重精神疾病还与癌症筛查差距以及更高的病死率有关。这种更高的病死率部分归因于治疗这些患者的特殊挑战，包括合并症、药物相互作用、无能力、以及由于精神症状而难以应对治疗方案。为了确保严重精神疾病患者得到有效治疗，所有相关的医疗保健专业人员，包括精神卫生服务人员和外科及肿瘤团队的人员，都需要解决护理不平等问题。
