Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
BMC Psychiatry. 2022 Aug 11;22(1):543. doi: 10.1186/s12888-022-04191-9.
Individuals with psychiatric disorders (PD) have a high prevalence of tobacco use. Patients with PD also potentially receive substandard care in comparison to the general population. Previous research has shown that individuals with PD have a decreased risk of receiving a tobacco related (TR) cancer diagnosis. To further assess this trend, this study assesses the survival of patients with a TR cancer with or without a PD.
Our study utilized multiple databases, with methods described elsewhere, to identify people in British Columbia that have been diagnosed with psychiatric disorders and appendicitis (our control group). From these groups, we selected individuals who also had a TR cancer. We subsequently extracted information pertaining to these patients from these databases.
Thirty-nine thousand eight hundred forty-one patients with cancer were included in our study. Analyses of these patients were controlled for by age, gender, cancer type and diagnosis year. This analysis displayed shorter survival time among patients who were diagnosed with depression (HR = 1.16; p = 0.01; 95% CI: 1.04-1.29), schizophrenia (HR = 1.62; p < 0.01; 95% CI: 1.43-1.84), or bipolar disorder (HR = 1.35; p < 0.01; 95% CI: 1.12-1.64) compared to the cancer patients without a PD, all of which were statistically significant. People that were diagnosed with anxiety disorders did not have a survival time that was significantly different from our control population (HR = 1.07; p = 0.22; 95% CI: 0.96-1.19).
Individuals with PD, except for those with anxiety, were found to have a shorter survival time following diagnosis with a TR cancer as compared to our control group. We hypothesize several factors, which may account for this statistically significant difference: (1) delayed diagnosis, (2) poor access to care, (3) poor assessment or follow-up, or (4) physician beliefs of poor treatment adherence.
精神障碍（PD）患者的烟草使用比例较高。与普通人群相比，PD 患者可能接受的医疗服务质量也较差。先前的研究表明，PD 患者罹患与烟草相关（TR）癌症的风险降低。为了进一步评估这一趋势，本研究评估了患有 TR 癌症的患者是否存在 PD 对其生存的影响。
我们的研究利用了多个数据库，并采用了先前描述的方法，从不列颠哥伦比亚省的患者中确定了患有精神障碍和阑尾炎（我们的对照组）的患者。从这些组中，我们选择了也患有 TR 癌症的患者。随后，我们从这些数据库中提取了与这些患者相关的信息。
我们的研究纳入了 39841 名癌症患者。对这些患者的分析通过年龄、性别、癌症类型和诊断年份进行了控制。分析显示，与没有 PD 的癌症患者相比，患有抑郁症（HR=1.16；p=0.01；95%CI：1.04-1.29）、精神分裂症（HR=1.62；p<0.01；95%CI：1.43-1.84）或双相情感障碍（HR=1.35；p<0.01；95%CI：1.12-1.64）的患者的生存时间更短，这些结果均具有统计学意义。被诊断为焦虑症的患者与我们的对照组相比，其生存时间没有明显差异（HR=1.07；p=0.22；95%CI：0.96-1.19）。
除了焦虑症患者外，患有 PD 的患者在被诊断出患有 TR 癌症后，其生存时间比我们的对照组更短。我们假设有几个因素可能导致了这一统计学上的显著差异：（1）诊断延迟，（2）医疗服务获取困难，（3）评估或随访不佳，或（4）医生认为治疗依从性差。
