Abstract
BackgroundNumerous studies have reported contradicting results on the relationship between cancer mortality and schizophrenia. Our aim is to quantify the mortality rate of common site-specific cancers among patients with schizophrenia and to synthesize the available research evidence.MethodsWe performed a systemic search of the PubMed, EMBASE and Web of Science databases. Studies reporting the mortality rate of different cancer in patients with schizophrenia were included. A random-effects model was applied to calculate the pooled relative risks (RRs) with 95% confidence intervals (95%CIs).ResultsSeven studies consisting of 1,162,971 participants with schizophrenia were included in this meta-analysis. Data regarding mortality risk of breast, colon, lung and prostate cancer among schizophrenia patients were subjected to quantitative analysis. Pooled results showed significant increases in mortality risk of breast cancer (RR = 1.97, 95%CI 1.38–2.83), lung cancer (RR = 1.93, 95%CI 1.46–2.54) and colon cancer (RR = 1.69, 95%CI 1.60–1.80) in patients with schizophrenia compared with those in the general population or control group. The mortality risk of prostate cancer increased in male patients, although no significant difference was detected (RR = 1.58, 95% CI 0.79–3.15). Increased risks of mortality from lung and colon cancer were observed in female patients (RR = 2.49, 95%CI 2.40–2.59 and RR = 2.42, 95%CI 1.39–4.22, respectively) and elevated risks of mortality from lung and colon cancer in male patients (RR = 2.40, 95%CI 2.30–2.50 and RR = 1.90, 95%CI 1.71–2.11, respectively) were detected.ConclusionsIndividuals with schizophrenia have a significantly high risk of mortality from breast, colon, and lung cancer.
Highlights
Numerous studies have reported contradicting results on the relationship between cancer mortality and schizophrenia
Studies eligible for inclusion in this meta-analysis must fulfill the following criteria: (1) can be searched for a full text document in English; (2) designed as a retrospective or prospective cohort or follow-up study; (3) the study population already had schizophrenia as a baseline with no history of cancer; (4) the general population or the participants without a diagnosis of schizophrenia formed the control group; and (5) mortality rate [reported as relative risks (RRs) or standard mortality ratios (SMRs) or hazard ratios (HRs) with 95% confidence intervals (95%Confidence intervals (CIs))] of some sitespecific cancers in patients with schizophrenia were documented or could be calculated using data derived from the corresponding article
After reviewing the unique titles and abstracts, 74 records appeared to be potentially relevant for inclusion in the meta-analysis
Summary
Numerous studies have reported contradicting results on the relationship between cancer mortality and schizophrenia. Individuals with schizophrenia have an extraordinarily short life expectancy and die approximately 10–20 years younger than the general population due to the high mortality, mostly resulting from poor medical care, unhealthy lifestyle factors, the side effects of antipsychotic medicine, and suicide [2,3,4]. As early as the 1990s, individuals with schizophrenia were reported to have a lower or similar risk of cancer mortality [6, 7], a finding that was supported by Giovanni Perini et al [8]. A metaanalysis by Zhou et al found a high risk of overall cancer mortality after a diagnosis of schizophrenia, but there was highly significant and inexplicable heterogeneity among studies [12]
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