Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
Epidemiol Psychiatr Sci. 2020 May 28;29:e132. doi: 10.1017/S204579602000044X.
Decades of research show that people with schizophrenia have an increased risk of death from cancer; however, the relationship between schizophrenia and cancer incidence remains less clear. This population-based study investigates the incidence of seven common types of cancer among people with a hospital diagnosis of schizophrenia and accounting for the effects of age, sex and calendar time.
This population-based study used 1990-2013 data from three nationwide Swedish registries to calculate the incidence (in total, by age group and by sex) of any cancer and of lung, oesophageal, pancreatic, stomach, colon, (in men) prostate and (in women) breast cancer in 111 306 people with a hospital diagnosis of schizophrenia. The incidence in people with diagnosed schizophrenia was compared with the incidence in the general population. Risk estimates accounted for the effects of calendar time.
In 1 424 829 person-years of follow-up, schizophrenia did not confer an overall higher cancer risk (IRR 1.02, 95% CI 0.91-1.13) but was associated with a higher risk for female breast (IRR 1.19, 95% CI 1.12-1.26), lung (IRR 1.42, 95% CI 1.28-1.58), oesophageal (IRR 1.25, 95% CI 1.07-1.46) and pancreatic (IRR 1.10, 95% CI 1.01-1.21) and a lower risk of prostate (IRR 0.66, 95% CI 0.55-0.79) cancer. Some age- and sex-specific differences in risk were observed.
People with schizophrenia do not have a higher overall incidence of cancer than people in the general population. However, there are significant differences in the risk of specific cancer types overall and by sex calling for efforts to develop disease-specific prevention programmes. In people with schizophrenia, higher risk generally occurs in those <75 years.
几十年来的研究表明，精神分裂症患者死于癌症的风险增加；然而，精神分裂症与癌症发病率之间的关系仍不明确。本基于人群的研究调查了 111306 名经医院诊断患有精神分裂症的人群中七种常见类型癌症的发病率（总体、按年龄组和性别），并考虑了年龄、性别和日历时间的影响。
本基于人群的研究使用了来自三个全瑞典登记处的 1990-2013 年数据，计算了 111306 名经医院诊断患有精神分裂症的人群中任何癌症以及肺癌、食管癌、胰腺癌、胃癌、结肠癌（男性）、前列腺癌（女性）和乳腺癌的发病率（总体、按年龄组和性别）。将诊断为精神分裂症的人群的发病率与普通人群的发病率进行比较。风险估计考虑了日历时间的影响。
在 1424829 人年的随访中，精神分裂症并没有导致整体更高的癌症风险（IRR 1.02，95%CI 0.91-1.13），但与女性乳腺癌（IRR 1.19，95%CI 1.12-1.26）、肺癌（IRR 1.42，95%CI 1.28-1.58）、食管癌（IRR 1.25，95%CI 1.07-1.46）和胰腺癌（IRR 1.10，95%CI 1.01-1.21）的风险增加有关，与前列腺癌（IRR 0.66，95%CI 0.55-0.79）的风险降低有关。观察到风险在年龄和性别方面存在一些特定差异。
精神分裂症患者的总体癌症发病率并不高于普通人群。然而，特定癌症类型的总体风险以及性别差异显著，需要努力制定针对特定疾病的预防计划。在精神分裂症患者中，风险较高一般发生在<75 岁的人群中。
