Excess Cancer Mortality in Psychiatric Patients
Excess Cancer Mortality in Psychiatric Patients
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DOI：
10.1177/070674370805301107
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发表时间：
2008-11-01
影响因子：
4
通讯作者：
Campbell, Leslie Anne
中科院分区：
文献类型：
--
作者：
Kisely, Stephen;Sadek, Joseph;Campbell, Leslie Anne
目的：精神病患者的癌症发病率和死亡率存在相互矛盾的数据，尽管大多数研究表明，虽然癌症死亡率较高，但发病率与普通人群没有什么不同。不同的方法和结果可能导致一些相互矛盾的结果。我们调查了精神疾病和癌症的发病率，首次入院率和死亡率之间的关联，在新斯科舍省使用一个标准的methodology.Method：一个基于人口的记录联系研究的247 344例患者在接触初级保健或专科精神卫生服务在1995年至2001年。结果：在与精神卫生服务机构接触的患者中，男性癌症死亡率高72%（95%CI，63%~ 82%），女性高59%（95%CI，49%~ 69%）。这反映在同样高的首次入院率上。然而，有较弱和不太一致的证据表明发病率增加。对于几个癌症部位，发病率比低于死亡率和首次入院率比的预期，并且不高于一般人群。这些是黑色素瘤，前列腺癌，膀胱癌，结直肠癌在mesel.Conclusion：人与精神疾病在新斯科舍省有癌症，这并不总是可以解释的发病率增加死亡率。对进一步研究的可能解释包括延迟检测或初始表现导致诊断时更先进的分期，以及沟通或获得医疗保健的困难。
Objectives: There are conflicting data oil cancer incidence and mortality in psychiatric patients, although most Studies suggest that while cancer mortality is higher, incidence is no different from that in the general population. Different methodologies and outcomes may account for some of the conflicting results. We investigated the association between mental illness and cancer incidence, first admission rates, and mortality in Nova Scotia using a standard methodology.Method: A population-based record-linkage study of 247 344 patients in contact with primary care or specialist mental health services during 1995 to 2001 Was used. Records were linked with cancer registrations and death records.Results: Cancer mortality was 72% higher in males (95%CI, 63% to 82%) and 59%) higher in females (95%CI, 49% to 69%) among patients in contact with mental health services. This was reflected in similarly elevated first admission rates. However, there was weaker and less consistent evidence for increased incidence. For several cancer sites, incidence rate ratios were lower than might be expected given the mortality and first admission rate ratios, and no higher than that of the general Population. These were melanoma, prostate, bladder, and colorectal cancers in males.Conclusion: People with mental illness in Nova Scotia have increased mortality from cancer, which cannot always be explained by increased incidence. Possible explanations for further study include delays in detection or initial presentation leading to more advanced staging at diagnosis, and difficulties ill communication or access to health care.