Department of Psychiatric Laboratory, Tianjin Medical University, Tianjin, China.
Department of Psychiatric Neuroimaging Faculty, Tianjin Mental Health Center, Tianjin, China.
JAMA Psychiatry. 2018 Apr 1;75(4):363-369. doi: 10.1001/jamapsychiatry.2017.4748.
Patients with schizophrenia are considered to have many risk factors for the development of cancer. However, the incidence of breast cancer in women with schizophrenia compared with the general population remains uncertain.
To perform an updated meta-analysis to evaluate the association between schizophrenia and the risk of breast cancer.
A systematic search of the PubMed and EMBASE databases was conducted using the search terms schizophrenia, schizophrenic, psychosis, combined with breast and cancer, tumor, neoplasm, or carcinoma. The final literature search was performed on August 15, 2017.
Cohort studies reporting the standardized incidence ratio (SIR) for the risk of breast cancer in women with schizophrenia compared with the general population.
The meta-analysis adhered to Meta-analysis of Observational Studies in Epidemiology and the Cochrane Handbook for Systematic Reviews of Interventions. Data extraction was performed independently. A random-effects model was used to pool the results, and a recently proposed prediction interval was calculated to describe the heterogeneity.
The SIR for the risk of breast cancer in women with schizophrenia compared with the general population or those without schizophrenia.
Twelve cohorts including 125 760 women were included in this meta-analysis. The results of the meta-analysis showed that schizophrenia was associated with a significantly increased risk of breast cancer incidence in women (SIR, 1.31; 95% CI, 1.14-1.50; P < .001), with significant heterogeneity (P < .001; I2 = 89%). Substantial between-study variance was also suggested by the wide prediction interval (0.81-2.10), which indicated that it is possible that a future study will show a decreased breast cancer risk in women with schizophrenia compared with the general population. The subgroup analysis results showed that the association was not significantly affected by whether breast cancer cases were excluded at baseline or the sample size of the included studies.
The incidence of breast cancer in women with schizophrenia is higher than that of the general female population. However, significant heterogeneity exists among the included studies. Women with schizophrenia deserve intensive prevention and treatment of breast cancer.
患有精神分裂症的患者被认为存在许多发生癌症的风险因素。然而，与普通人群相比，精神分裂症女性患者乳腺癌的发病率仍不确定。
进行一项更新的荟萃分析，以评估精神分裂症与乳腺癌风险之间的关联。
使用精神分裂症、精神分裂、精神病、乳腺癌和癌症、肿瘤、新生物或癌等检索词，对 PubMed 和 EMBASE 数据库进行了系统检索。最后一次文献检索于 2017 年 8 月 15 日进行。
报告与普通人群相比，精神分裂症女性患者乳腺癌风险的标准化发病率比（SIR）的队列研究。
荟萃分析遵循观察性研究的荟萃分析流行病学和系统评价干预措施的 Cochrane 手册。数据提取由独立人员完成。采用随机效应模型汇总结果，并计算最近提出的预测区间以描述异质性。
与普通人群或无精神分裂症的女性相比，精神分裂症女性乳腺癌发病风险的 SIR。
本荟萃分析纳入了 12 项队列研究，共纳入了 125760 名女性。荟萃分析结果表明，精神分裂症与女性乳腺癌发病风险显著增加相关（SIR，1.31；95% CI，1.14-1.50；P<0.001），存在显著的异质性（P<0.001；I2=89%）。较宽的预测区间（0.81-2.10）也表明研究间存在较大的差异，这表明未来的研究可能显示精神分裂症女性的乳腺癌风险较普通人群降低。亚组分析结果表明，无论是否在基线时排除乳腺癌病例或纳入研究的样本量，该关联均不受影响。
精神分裂症女性患者乳腺癌的发病率高于普通女性人群。然而，纳入的研究之间存在显著的异质性。精神分裂症女性需要对乳腺癌进行强化预防和治疗。
