Cancer incidence in young and middle-aged people with schizophrenia: nationwide cohort study in Taiwan, 2000–2010

L. Y. Chen, Yen-Ni Hung, Ying Yeh Chen, Shu Yu Yang, Chun-Hung Pan, Chiao Chicy Chen, Chian Jue Kuo

Research output: Contribution to journalArticle

Abstract

Aims.: For nearly a century, the incidence of cancer in people with schizophrenia was lower than in the general population. In the recent decade, the relationship between cancer and schizophrenia has become obscured. Thus, we investigated the cancer risk among young and middle-aged patients with schizophrenia. Methods.: Records of newly admitted patients with schizophrenia (n = 32 731) from January 2000 through December 2008 were retrieved from the Psychiatric Inpatient Medical Claims database in Taiwan, and the first psychiatric admission of each patient during the same period was defined as the baseline. We obtained 514 incident cancer cases that were monitored until December 2010. Standardised incidence ratios (SIRs) were calculated to compare the risk of cancer between those with schizophrenia and the general population. Stratified analyses of cancer incidences were performed by gender, site of cancers and duration since baseline (first psychiatric admission). Results.: The incidence of cancer for all sites was slightly higher than that of the general population for the period (SIR = 1.15 [95% CI 1.06–1.26], p = 0.001). Men had a significantly higher incidence of colorectal cancer (SIR = 1.48 [95% CI 1.06–2.06], p = 0.019). Women had a higher incidence of breast cancer (SIR = 1.47 [95% CI 1.22–1.78], p < 0.001). Intriguingly, the risk for colorectal cancer was more pronounced 5 years after the first psychiatric admission rather than earlier (SIR = 1.94 [1.36–2.75], p < 0.001) and so was the risk for breast cancer (SIR = 1.85 [1.38–2.48], p < 0.001). The cancer incidence was higher in patients with schizophrenia contradicting the belief that schizophrenia was protective of cancers. Conclusions.: Our analyses suggest that men and women with schizophrenia were more vulnerable to certain types of cancers, which indicates the need for gender-specific cancer screening programs. The fact that risk of colorectal cancer was more pronounced 5 years after the first psychiatric admission could imply the impact of unhealthy lifestyles or the possibility of delayed diagnoses.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalEpidemiology and Psychiatric Sciences
DOIs
Publication statusAccepted/In press - Nov 21 2016

Fingerprint

Taiwan
Schizophrenia
Cohort Studies
Incidence
Neoplasms
Psychiatry
Colorectal Neoplasms
Breast Neoplasms
Population
Patient Admission
Delayed Diagnosis
Early Detection of Cancer
Life Style
Inpatients
Databases

Keywords

  • Breast cancer
  • cancer
  • colorectal cancer
  • schizophrenia
  • standardised incidence ratio (SIR)

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

Cite this

Cancer incidence in young and middle-aged people with schizophrenia : nationwide cohort study in Taiwan, 2000–2010. / Chen, L. Y.; Hung, Yen-Ni; Chen, Ying Yeh; Yang, Shu Yu; Pan, Chun-Hung; Chen, Chiao Chicy; Kuo, Chian Jue.

In: Epidemiology and Psychiatric Sciences, 21.11.2016, p. 1-11.

Research output: Contribution to journalArticle

Chen, L. Y. ; Hung, Yen-Ni ; Chen, Ying Yeh ; Yang, Shu Yu ; Pan, Chun-Hung ; Chen, Chiao Chicy ; Kuo, Chian Jue. / Cancer incidence in young and middle-aged people with schizophrenia : nationwide cohort study in Taiwan, 2000–2010. In: Epidemiology and Psychiatric Sciences. 2016 ; pp. 1-11.
@article{9eafe7655fe642fc822447e10a76e85e,
title = "Cancer incidence in young and middle-aged people with schizophrenia: nationwide cohort study in Taiwan, 2000–2010",
abstract = "Aims.: For nearly a century, the incidence of cancer in people with schizophrenia was lower than in the general population. In the recent decade, the relationship between cancer and schizophrenia has become obscured. Thus, we investigated the cancer risk among young and middle-aged patients with schizophrenia. Methods.: Records of newly admitted patients with schizophrenia (n = 32 731) from January 2000 through December 2008 were retrieved from the Psychiatric Inpatient Medical Claims database in Taiwan, and the first psychiatric admission of each patient during the same period was defined as the baseline. We obtained 514 incident cancer cases that were monitored until December 2010. Standardised incidence ratios (SIRs) were calculated to compare the risk of cancer between those with schizophrenia and the general population. Stratified analyses of cancer incidences were performed by gender, site of cancers and duration since baseline (first psychiatric admission). Results.: The incidence of cancer for all sites was slightly higher than that of the general population for the period (SIR = 1.15 [95{\%} CI 1.06–1.26], p = 0.001). Men had a significantly higher incidence of colorectal cancer (SIR = 1.48 [95{\%} CI 1.06–2.06], p = 0.019). Women had a higher incidence of breast cancer (SIR = 1.47 [95{\%} CI 1.22–1.78], p < 0.001). Intriguingly, the risk for colorectal cancer was more pronounced 5 years after the first psychiatric admission rather than earlier (SIR = 1.94 [1.36–2.75], p < 0.001) and so was the risk for breast cancer (SIR = 1.85 [1.38–2.48], p < 0.001). The cancer incidence was higher in patients with schizophrenia contradicting the belief that schizophrenia was protective of cancers. Conclusions.: Our analyses suggest that men and women with schizophrenia were more vulnerable to certain types of cancers, which indicates the need for gender-specific cancer screening programs. The fact that risk of colorectal cancer was more pronounced 5 years after the first psychiatric admission could imply the impact of unhealthy lifestyles or the possibility of delayed diagnoses.",
keywords = "Breast cancer, cancer, colorectal cancer, schizophrenia, standardised incidence ratio (SIR)",
author = "Chen, {L. Y.} and Yen-Ni Hung and Chen, {Ying Yeh} and Yang, {Shu Yu} and Chun-Hung Pan and Chen, {Chiao Chicy} and Kuo, {Chian Jue}",
year = "2016",
month = "11",
day = "21",
doi = "10.1017/S2045796016000883",
language = "English",
pages = "1--11",
journal = "Epidemiology and Psychiatric Sciences",
issn = "2045-7960",
publisher = "Cambridge University Press",

}

TY - JOUR

T1 - Cancer incidence in young and middle-aged people with schizophrenia

T2 - nationwide cohort study in Taiwan, 2000–2010

AU - Chen, L. Y.

AU - Hung, Yen-Ni

AU - Chen, Ying Yeh

AU - Yang, Shu Yu

AU - Pan, Chun-Hung

AU - Chen, Chiao Chicy

AU - Kuo, Chian Jue

PY - 2016/11/21

Y1 - 2016/11/21

N2 - Aims.: For nearly a century, the incidence of cancer in people with schizophrenia was lower than in the general population. In the recent decade, the relationship between cancer and schizophrenia has become obscured. Thus, we investigated the cancer risk among young and middle-aged patients with schizophrenia. Methods.: Records of newly admitted patients with schizophrenia (n = 32 731) from January 2000 through December 2008 were retrieved from the Psychiatric Inpatient Medical Claims database in Taiwan, and the first psychiatric admission of each patient during the same period was defined as the baseline. We obtained 514 incident cancer cases that were monitored until December 2010. Standardised incidence ratios (SIRs) were calculated to compare the risk of cancer between those with schizophrenia and the general population. Stratified analyses of cancer incidences were performed by gender, site of cancers and duration since baseline (first psychiatric admission). Results.: The incidence of cancer for all sites was slightly higher than that of the general population for the period (SIR = 1.15 [95% CI 1.06–1.26], p = 0.001). Men had a significantly higher incidence of colorectal cancer (SIR = 1.48 [95% CI 1.06–2.06], p = 0.019). Women had a higher incidence of breast cancer (SIR = 1.47 [95% CI 1.22–1.78], p < 0.001). Intriguingly, the risk for colorectal cancer was more pronounced 5 years after the first psychiatric admission rather than earlier (SIR = 1.94 [1.36–2.75], p < 0.001) and so was the risk for breast cancer (SIR = 1.85 [1.38–2.48], p < 0.001). The cancer incidence was higher in patients with schizophrenia contradicting the belief that schizophrenia was protective of cancers. Conclusions.: Our analyses suggest that men and women with schizophrenia were more vulnerable to certain types of cancers, which indicates the need for gender-specific cancer screening programs. The fact that risk of colorectal cancer was more pronounced 5 years after the first psychiatric admission could imply the impact of unhealthy lifestyles or the possibility of delayed diagnoses.

AB - Aims.: For nearly a century, the incidence of cancer in people with schizophrenia was lower than in the general population. In the recent decade, the relationship between cancer and schizophrenia has become obscured. Thus, we investigated the cancer risk among young and middle-aged patients with schizophrenia. Methods.: Records of newly admitted patients with schizophrenia (n = 32 731) from January 2000 through December 2008 were retrieved from the Psychiatric Inpatient Medical Claims database in Taiwan, and the first psychiatric admission of each patient during the same period was defined as the baseline. We obtained 514 incident cancer cases that were monitored until December 2010. Standardised incidence ratios (SIRs) were calculated to compare the risk of cancer between those with schizophrenia and the general population. Stratified analyses of cancer incidences were performed by gender, site of cancers and duration since baseline (first psychiatric admission). Results.: The incidence of cancer for all sites was slightly higher than that of the general population for the period (SIR = 1.15 [95% CI 1.06–1.26], p = 0.001). Men had a significantly higher incidence of colorectal cancer (SIR = 1.48 [95% CI 1.06–2.06], p = 0.019). Women had a higher incidence of breast cancer (SIR = 1.47 [95% CI 1.22–1.78], p < 0.001). Intriguingly, the risk for colorectal cancer was more pronounced 5 years after the first psychiatric admission rather than earlier (SIR = 1.94 [1.36–2.75], p < 0.001) and so was the risk for breast cancer (SIR = 1.85 [1.38–2.48], p < 0.001). The cancer incidence was higher in patients with schizophrenia contradicting the belief that schizophrenia was protective of cancers. Conclusions.: Our analyses suggest that men and women with schizophrenia were more vulnerable to certain types of cancers, which indicates the need for gender-specific cancer screening programs. The fact that risk of colorectal cancer was more pronounced 5 years after the first psychiatric admission could imply the impact of unhealthy lifestyles or the possibility of delayed diagnoses.

KW - Breast cancer

KW - cancer

KW - colorectal cancer

KW - schizophrenia

KW - standardised incidence ratio (SIR)

UR - http://www.scopus.com/inward/record.url?scp=84995801561&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995801561&partnerID=8YFLogxK

U2 - 10.1017/S2045796016000883

DO - 10.1017/S2045796016000883

M3 - Article

AN - SCOPUS:84995801561

SP - 1

EP - 11

JO - Epidemiology and Psychiatric Sciences

JF - Epidemiology and Psychiatric Sciences

SN - 2045-7960

ER -