Schizophrenia and breast cancer incidence A systematic review of clinical studies
Schizophrenia and breast cancer incidence A systematic review of clinical studies
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DOI：
10.1016/j.schres.2009.07.012
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发表时间：
2009-10-01
影响因子：
4.5
通讯作者：
Hodgson, Richard E.
中科院分区：
文献类型：
--
作者：
Bushe, Chris J.;Bradley, Andrew J.;Hodgson, Richard E.
目的：检查精神分裂症患者乳腺癌发病率的研究报告，与普通人群相比，精神分裂症患者的发病率增加、减少或相似。我们对已发表的数据进行了系统的回顾，以调查产生不同结果的可能原因。方法：根据流行病学观察性研究荟萃分析（MOOSE）组的建议进行综述[Stroup， d.f., Berlin, j.a., Morton, s.c., Olkin， I., Williamson, g.d., Rennie， D., Moher， D., Becker, b.j., Sipe, t.a., Thacker， S.B. 2000]。流行病学观察性研究的荟萃分析：报告的建议。流行病学（MOOSE）组观察性研究的meta分析。《美国医学协会杂志》上。283(15) 2008 - 2012。]。方法问题（质量标记）可以解释数据的可变性。提取了与这些问题和标准发病率有关的数据。然后将结果与这些质量标记进行解释。结果：数据来自13项研究的6000多名女性精神分裂症患者，并与1986年至2008年相关国家年龄匹配的一般人群进行了比较。虽然结果差异很大，从风险增加52%到降低40%不等，但这些数据可以从队列年龄、规模和随访时间作为混杂因素来理解。13项研究中有6项报告乳腺癌发病率增加或略有增加。这些研究往往有超过100例乳腺癌病例，超过10万人的随访时间，以及年龄较大的人群。结论：女性精神分裂症患者患乳腺癌的风险可能增加。研究结果的不一致可能是由于方法学问题，如统计效力低和研究队列的年龄范围。没有证实的风险因素可以解释这些数据；然而，胎次减少和高泌乳素血症可能是推测的病因。考虑对女性精神分裂症患者进行乳腺癌筛查对临床医生和研究人员都很重要。(C) 2009 Elsevier B.V.版权所有
Objectives: Studies examining the incidence of breast cancer in schizophrenia patients report increased, reduced or similar incidence compared to the general population. We undertook a systematic review of published data to investigate possible reasons for the variable findings.Methods: The review was conducted according to the recommendations of the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) group [Stroup, D.F., Berlin, J.A., Morton, S.C., Olkin, I., Williamson, G.D., Rennie, D., Moher, D., Becker, B.J., Sipe, T.A., Thacker, S.B. 2000. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA. 283(15) 2008-2012.]. Methodological issues (Quality Markers) that may explain the variability in the data were identified. Data relating to these issues and the standard incidence rates were extracted. Results were then interpreted in relation to these quality markers.Results: Data are available from over 6000 female patients with schizophrenia from 13 studies and are reported in comparison to age matched general populations from the relevant country from 1986 to 2008. Although results are widely discrepant ranging from 52% increase in risk to 40% decrease, these data may be understood in terms of cohort age, size and length of follow up as the confounders. Six of 13 studies report an increased or marginally increased incidence of breast cancer. These tend to be studies with more than 100 incident cases of breast cancer, greater than 100,000 person years follow up and older populations.Conclusions: Breast cancer may be increased in female subjects with schizophrenia. Inconsistencies in study findings may be due to methodological issues such as low statistical power and the age range of cohorts studied. There is no proven risk factor to explain these data; however reduced parity and hyperprolactinaemia may represent putative aetiological factors. Consideration of screening of female patients with schizophrenia for breast cancer is important for clinicians and researchers. (C) 2009 Elsevier B.V. All rights reserved.