Yang Ji Su, Kang Sunghyuk, Kim Kwanghyun, Tsai Alexander C, Cho Chul-Hyun, Jung Sun Jae
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Massachusetts, USA.
Br J Psychiatry. 2025 Apr;226(4):206-212. doi: 10.1192/bjp.2024.170. Epub 2024 Oct 31.
Breast cancer is a major global health issue, especially among women. Previous research has indicated a possible association between psychiatric conditions, particularly schizophrenia, and an increased risk of breast cancer. However, the specific risk of breast cancer in women with schizophrenia, compared with those with other psychiatric disorders and the general population, remains controversial and needs further clarification.
To estimate the risk of breast cancer among people with schizophrenia compared with people with other psychiatric disorders and people in the general population.
We utilised medical claims data of women aged 18 to 80 years in the Korean National Health Information Database from 2007 to 2018. Individuals with schizophrenia were defined as women with ICD-10 codes F20 or F25 ( = 224 612). The control groups were defined as women with other psychiatric disorders ( = 224 612) and women in the general Korean population ( = 449 224). Cases and controls were matched by index date and age, in a 1:1:2 ratio. We estimated the hazard of breast cancer using the Cox proportional hazards model, adjusting for insurance premiums and medical comorbidities. Among the people with schizophrenia, we used the landmark method to estimate the association between duration of antipsychotic medication use and the incidence of breast cancer.
In multivariable Cox regression models, the hazard rate of breast cancer was 1.26 times higher in the people with schizophrenia than in the general population (95% CI: 1.20-1.32). In comparison with the psychiatric patient group, the hazard ratio was 1.17 (95% CI: 1.11-1.28). Among women with schizophrenia, the hazard of breast cancer was greater among those who took antipsychotic medications for 1 year or more compared with those who took antipsychotics for less than 6 months.
Women with schizophrenia have an elevated risk of breast cancer, and long-term use of antipsychotics is associated with an increased risk of breast cancer.
乳腺癌是一个重大的全球健康问题，在女性中尤为突出。先前的研究表明，精神疾病，尤其是精神分裂症，与乳腺癌风险增加之间可能存在关联。然而，与患有其他精神疾病的女性和普通人群相比，精神分裂症女性患乳腺癌的具体风险仍存在争议，需要进一步阐明。
评估精神分裂症患者与其他精神疾病患者及普通人群相比患乳腺癌的风险。
我们利用了2007年至2018年韩国国家健康信息数据库中18至80岁女性的医疗理赔数据。精神分裂症患者定义为国际疾病分类第十版（ICD - 10）编码为F20或F25的女性（n = 224612）。对照组定义为患有其他精神疾病的女性（n = 224612）和韩国普通人群中的女性（n = 449224）。病例和对照按索引日期和年龄以1:1:2的比例进行匹配。我们使用Cox比例风险模型估计乳腺癌风险，并对保险费和合并症进行了调整。在精神分裂症患者中，我们采用标志性方法估计抗精神病药物使用时长与乳腺癌发病率之间的关联。
在多变量Cox回归模型中，精神分裂症患者患乳腺癌的风险率比普通人群高1.26倍（95%置信区间：1.20 - 1.32）。与精神疾病患者组相比，风险比为1.17（95%置信区间：1.11 - 1.28）。在患有精神分裂症的女性中，服用抗精神病药物1年或更长时间的女性患乳腺癌的风险高于服用抗精神病药物少于6个月的女性。
精神分裂症女性患乳腺癌的风险升高，长期使用抗精神病药物与乳腺癌风险增加有关。
