Cancer in schizophrenia: is the risk higher or lower?
Cancer in schizophrenia: is the risk higher or lower?
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DOI：
10.1016/j.schres.2004.06.016
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发表时间：
2005-03-01
影响因子：
4.5
通讯作者：
Levav, I
中科院分区：
文献类型：
--
作者：
Grinshpoon, A;Barchana, M;Levav, I
探索精神分裂症和癌症之间关系的研究显示了相互矛盾的结果。我们的研究探讨了这种关联在三个犹太-以色列人口群体定义他们的大陆/出生地（以色列，欧洲-美洲和非洲-亚洲）。通过全国精神病和癌症登记处的联系确定了患者。将诊断为精神分裂症的患者的癌症发病率与一般人群的发病率进行比较。结果显示，所有部位的癌症标准化发病率（SIR）在男性和女性精神分裂症患者中均显著较低，分别为0.86（95%置信区间（CI）0.80-0.93）和0.91（95% CI 0.85-0.97）。这种降低的总体风险在欧美出生的人中最为明显，男性（SIR 0.85，95% CI 0.74-0.97）和女性（SIR 0.86，95% CI 0.77-0.94）都是如此。在被诊断为精神分裂症的妇女中，出生在亚非地区的妇女乳腺癌（1.37，95% CI 1.12-1.63）和出生在以色列的妇女子宫体癌（2.75，95% CI 1.69-3.81）的SIR在统计学上高于一般人群。在亚非出生的男性中，诊断为精神分裂症的肺癌患者显著高于各自的对照人群（1.58，95%CI 1.13-2.2）。我们的研究结果和文献结果证明，进行一项多国研究是合理的，该研究包括确定精神分裂症患者及其家属中癌症相关的危险因素，以及精神药物的使用信息。这一努力可能会澄清一个悬而未决的流行病学之谜。(C)2004 Elsevier B. V.保留所有权利。
Studies exploring the relationship between schizophrenia and cancer have shown conflicting results. Our study explores this association in three Jewish-Israeli population groups defined by their continent/place of birth (Israel, Europe-America, and Africa-Asia). The identification of the patients was made through the linkage of the nationwide psychiatric and cancer registries. The incidence of cancer in patients diagnosed with schizophrenia was compared with the incidence in the general population. The results showed that the cancer standardized incidence ratios (SIRs) for all sites were significantly lower among men and women with schizophrenia, 0.86 [95% confidence interval (CI) 0.80-0.93] and 0.91 (95% Cl 0.85-0.97), respectively. This reduced overall risk was clearest for those born in Europe-America, both men (SIR 0.85, 95% CI 0.74-0.97) and women (SIR 0.86, 95% CI 0.77-0.94). Among women diagnosed with schizophrenia, the SIR was statistically higher for cancer in the breast among those born in Asia-Africa (1.37, 95% CI 1.12-1.63) and in the corpus uteri among the Israel-bom (2.75, 95% Cl 1.69-3.81) than among their counterparts in the general population. Lung cancer was significantly higher in men born in Asia-Africa diagnosed with schizophrenia than in the respective comparison population group (1.58, 95% CI 1.13-2.2).Our findings, and those of the literature, justify conducting a multinational study that includes identification of cancer-related risk factors among patients with schizophrenia and their families, and information on the use of psychotropic medications. This effort may clarify an epidemiological puzzle that remains outstanding. (C) 2004 Elsevier B.V. All rights reserved.