Department of Radiation Oncology, BC Cancer-Prince George, 1215 Lethbridge Street, Prince George, BC V2M 7E9, Canada.
Department of Surgery, Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
Curr Oncol. 2021 Nov 24;28(6):4953-4960. doi: 10.3390/curroncol28060415.
Individuals with psychiatric disorders (PD) have a high prevalence of tobacco use. Therefore, we assessed the hazard of receiving a tobacco-related (TR) cancer diagnosis among individuals with PD.
Several population-based provincial databases were used to identify individuals in BC diagnosed with depression, schizophrenia, bipolar disorder, anxiety disorders, or multiple PD between 1990 and 2013. A primary population proxy comparison group (appendicitis) was also identified and matched to the psychiatric cohort based on age at cohort entry, gender, year of cohort entry, and postal code. We linked individuals in the cohort and comparison groups with the BC Cancer Registry. Using a competing risks approach, we estimated the effect of having a PD on the risk of receiving a TR cancer diagnosis, in light of the competing risk of mortality.
In total, 165,289 patients were included. Individuals with depression (HR = 0.81; < 0.01; 95% CI: 0.73-0.91), anxiety disorders (HR = 0.84; = 0.02; 95% CI: 0.73-0.97), or multiple PD (HR = 0.74; < 0.01; 95% CI: 0.66-0.83) had a statistically significant lower risk of a TR cancer diagnosis compared to the comparison group. Individuals with schizophrenia (HR = 0.86; = 0.40; 95% CI: 0.62-1.21) or bipolar disorder (HR = 0.58; = 0.12; 95% CI: 0.29-1.14), however, showed no evidence of a statistically significant difference from the comparison group.
We found that individuals with depression, anxiety disorders, or multiple PD diagnoses had a significantly reduced risk of receiving a tobacco-related cancer diagnosis. These results were unexpected and could be explained by individuals with a PD having barriers to a cancer diagnosis rather than a true decreased incidence.
患有精神疾病（PD）的个体吸烟率较高。因此，我们评估了 PD 个体接受与烟草相关（TR）癌症诊断的风险。
使用多个基于人群的省级数据库，确定了 1990 年至 2013 年间在不列颠哥伦比亚省被诊断患有抑郁症、精神分裂症、双相情感障碍、焦虑症或多种 PD 的个体。还确定了一个主要的人群代理对照组（阑尾炎），并根据队列进入年龄、性别、队列进入年份和邮政编码与精神科队列相匹配。我们将队列和对照组中的个体与不列颠哥伦比亚癌症登记处相联系。使用竞争风险方法，我们根据死亡率的竞争风险，估计 PD 对接受 TR 癌症诊断的风险的影响。
共有 165289 名患者被纳入研究。与对照组相比，患有抑郁症（HR=0.81，<0.01；95%CI：0.73-0.91）、焦虑症（HR=0.84，=0.02；95%CI：0.73-0.97）或多种 PD（HR=0.74，<0.01；95%CI：0.66-0.83）的个体患 TR 癌症的风险有统计学意义降低。然而，患有精神分裂症（HR=0.86，=0.40；95%CI：0.62-1.21）或双相情感障碍（HR=0.58，=0.12；95%CI：0.29-1.14）的个体与对照组相比，没有统计学意义上的差异。
我们发现，患有抑郁症、焦虑症或多种 PD 诊断的个体接受与烟草相关的癌症诊断的风险显著降低。这些结果出乎意料，可能是由于 PD 患者存在癌症诊断障碍，而不是真正的发病率降低。
