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精神分裂症患者肺癌发病率:荟萃分析。

Lung cancer incidence in patients with schizophrenia: meta-analysis.

机构信息

Professor, Department of Psychiatric-Neuroimaging-Genetics Laboratory, Tianjin Anding Hospital; Department of Psychiatry and Comorbidity, Mental Health Teaching Hospital, Tianjin Medical University; Department of Psychiatry, Jinning Medical University; and Department of Psychiatry, Wenzhou Seventh People's Hospital, China.

Professor, Department of Radiation Oncology, Peking University Third Hospital, China.

出版信息

Br J Psychiatry. 2019 Dec;215(6):704-711. doi: 10.1192/bjp.2019.23.

Abstract

BACKGROUND

Lung cancer risk factors, like tobacco smoking, are highly prevalent in patients with schizophrenia. Whether these patients have a higher risk of lung cancer remains unknown.

AIMS

We aimed to investigate whether patients with schizophrenia have a higher incidence of lung cancer compared with general population, in a meta-analysis.

METHOD

Eligible studies were searched from PubMed and EMBASE databases to identify cases of lung cancer in patients with schizophrenia and the general population. This meta-analysis utilised the random-effects model and prediction interval was used to calculate the heterogeneity of these eligible studies. We assessed the quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

There were 12 studies, totalling 496 265 patients, included in this meta-analysis. The data showed that the baseline schizophrenia diagnosis was not associated with any changes in lung cancer incidence in the overall population, with a standardised incidence ratio of 1.11 (95% CI 0.90-1.37; P = 0.31), although there was a significant heterogeneity among these studies (I2 = 94%). Moreover, there was also a substantial between-study variance with wide prediction interval values (0.47-2.64). The data were consistent for both males and females.

CONCLUSIONS

Up-to-date evidence from epidemiological studies indicates the lack of certainty about the association between schizophrenia diagnosis and lung cancer incidence.

摘要

背景

肺癌的危险因素,如吸烟,在精神分裂症患者中非常普遍。这些患者是否有更高的肺癌风险尚不清楚。

目的

我们旨在通过荟萃分析研究精神分裂症患者的肺癌发病率是否高于普通人群。

方法

从 PubMed 和 EMBASE 数据库中搜索符合条件的研究,以确定精神分裂症患者和普通人群中的肺癌病例。本荟萃分析采用随机效应模型,并使用预测区间计算这些合格研究的异质性。我们使用推荐评估、制定和评估(GRADE)方法评估证据质量。

结果

本荟萃分析共纳入了 12 项研究,总计 496265 名患者。数据显示,总体人群中基线精神分裂症诊断与肺癌发病率的任何变化均无关联,标准化发病率比为 1.11(95%CI 0.90-1.37;P=0.31),尽管这些研究存在显著的异质性(I2=94%)。此外,研究之间也存在很大的方差,预测区间值范围较宽(0.47-2.64)。数据对男性和女性均一致。

结论

来自流行病学研究的最新证据表明,精神分裂症诊断与肺癌发病率之间的关联尚不确定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8275/7557637/4b0a5aa2d82b/S0007125019000230_fig1.jpg

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