Mortensen P B
Institute of Psychiatric Demography, Aarhus Psychiatric Hospital, Risskov, Denmark.
J Epidemiol Community Health. 1989 Mar;43(1):43-7. doi: 10.1136/jech.43.1.43.
A cohort of 6168 schizophrenic patients was followed from 1957 to 1984 to determine the incidence of cancer in these patients. In the male schizophrenic patients the incidence of cancer was found to be significantly reduced in comparison with the general Danish population. This reduction was especially marked for cancer in the respiratory system, cancer of the prostate and cancer of the bladder. In the female patients the overall incidence of cancer did not differ from that of the general Danish population, but there was an increased risk of cancer of the digestive tract, especially cancer of the pancreas and a slight increase of the risk of breast cancer. In the female patients the risk of respiratory cancers and cancer of the female genital organs, especially cancer of the uterine cervix, was reduced. These alterations of the incidence of cancer in schizophrenic patients cannot be ascribed to differences in diagnostic accuracy. As a possible explanation of these findings a reduced exposure to well known carcinogens such as cigarette smoke may be relevant. We speculate that exposure to neuroleptics such as phenothiazines and reserpine may also be part of the explanation for the findings.
1957年至1984年期间,对6168名精神分裂症患者进行了随访,以确定这些患者中癌症的发病率。结果发现,男性精神分裂症患者的癌症发病率与丹麦普通人群相比显著降低。这种降低在呼吸系统癌症、前列腺癌和膀胱癌方面尤为明显。女性患者的总体癌症发病率与丹麦普通人群没有差异,但消化道癌症的风险增加,尤其是胰腺癌,乳腺癌风险略有增加。女性患者患呼吸道癌症和女性生殖器官癌症,尤其是宫颈癌的风险降低。精神分裂症患者癌症发病率的这些变化不能归因于诊断准确性的差异。作为这些发现的一种可能解释,减少接触众所周知的致癌物如香烟烟雾可能与之相关。我们推测,接触诸如吩噻嗪和利血平之类的抗精神病药物也可能是这些发现的部分原因。