Cancer mortality in patients with schizophrenia: systematic review and meta-analysis

Zhuo, Chuanjun; Tao, Ran; Jiang, Ronghuan; Lin, Xiaodong; Shao, Mingjing

doi:10.1192/bjp.bp.116.195776

Cited by 70 publications

(68 citation statements)

References 53 publications

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“…Increased expression of Gal/GalNAc associated enzymes and glycan structures are common in various cancers (Schneider et al, 2017;Xie et al, 2018Xie et al, , 2016Zhou et al, 2013Zhou et al, , 2012 and schizophrenia patients diagnosed with cancer tend to have a longer delay to diagnosis, worse treatment outcomes, and higher mortality rates (Abdullah et al, 2015;Bergamo et al, 2014;Irwin et al, 2017;Ishikawa et al, 2016;Lawrence et al, 2000;Safdieh et al, 2017;Sathianathen et al, 2019;Zhuo et al, 2017). Since we have identified decreased levels of B4GALT1 and GALNT16 in schizophrenia, it is possible that established biomarkers for cancer diagnosis do not have the same degree of predictive accuracy for schizophrenia patients.…”

Section: Discussionmentioning

confidence: 91%

Altered protein expression of galactose and N-acetylgalactosamine transferases in schizophrenia superior temporal gyrus

Mueller

Mallepalli

Meador‐Woodruff

2019

Preprint

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Abnormal glycosylation in schizophrenia brain has been previously implicated in disruptions to protein trafficking, localization, and function. Glycosylation is an enzyme-mediated posttranslational modification and, along with reports of altered glycan biosynthesis and abnormal glycan levels in peripheral fluids, growing evidence for altered glycosylation pathway activity in schizophrenia prompted investigation of specific enzymes which may be responsible for these abnormalities. Glycosylation is a highly variable yet tightly controlled cellular process and, depending on the molecule(s) affected, altered glycan modifications can influence the trajectory of many key functional pathways. In a preliminary gene array study, abnormal transcript expression of 36 glycosylation-associated enzymes was identified in schizophrenia brain. Subsequently, protein expression abnormalities of enzymes which act on glucose (UGGT2), mannose (EDEM2), fucose (FUT8, POFUT2), and N-acetylglucosamine (MGAT4A, B3GNT8) have been reported in this illness. The current study investigates protein expression levels by western blot analysis of the galactose and N-acetylgalactosamine (GalNAc) transferases B3GALTL1, B4GALT1, C1GALT1, GALNT2, GALNT7, GALNT16, and GALNTL5, as well as a related chaperone protein, COSMC, in superior temporal gyrus of age-and sex-matched pairs of schizophrenia and non-psychiatrically ill comparison subjects (N = 16 pairs). In schizophrenia, reduced β-1,4-galactosyltransferase 1 (B4GALT1) and polypeptide GalNAc-transferase 16 (GALNT16) were identified. These findings add support to the hypothesis that dysregulated glycosylation-associated enzyme expression contributes to altered protein glycosylation and downstream substrate-specific defects in schizophrenia.

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Section: Discussionmentioning

confidence: 91%

Altered protein expression of galactose and N-acetylgalactosamine transferases in schizophrenia superior temporal gyrus

Mueller

Mallepalli

Meador‐Woodruff

2019

Preprint

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“…A specific, related aspect is that this study did not involve patients with severe mental illness (eg, schizophrenia, bipolar disorders, severe personality disorders), for whom the possible use of screening tools for distress should be part of more specific studies. Indeed, the problem of cancer among patients who have severe mental illness and the needs for integrated assessment and intervention deserve to be urgently examined . Third, because of the cross‐sectional nature of the study, conclusions regarding the reliability of the instruments over time, across the illness trajectory, are not possible.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the problem of cancer among patients who have severe mental illness and the needs for integrated assessment and intervention deserve to be urgently examined. 75,76 Third, because of the cross-sectional nature of the study, conclusions regarding the reliability of the instruments over time, across the illness trajectory, are not possible. The importance of prospective evaluation was underlined in a recent, large, prospective German study, 77 which reported a 31.8% prevalence of mental disorders 4 weeks after diagnosis and a 39.8% prevalence at 12 months using the same instrument we used (CIDI).…”

Section: Discussionmentioning

confidence: 99%

Screening for emotional disorders in patients with cancer using the Brief Symptom Inventory (BSI) and the BSI‐18 versus a standardized psychiatric interview (the World Health Organization Composite International Diagnostic Interview)

Grassi

Caruso

Mitchell

et al. 2018

Cancer

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“…A meta-analysis published in 2017 revealed that patients with schizophrenia have a slightly decreased risk of overall cancer incidence compared with the general population [25]. Another meta-analysis based on 16 cohort studies showed a high risk of cancer mortality in individuals with schizophrenia [12]. Different from the results of subgroup analysis stratified by cancer type [25], Zhuo et al described that female schizophrenia faced a higher incidence of breast cancer than the general population in a meta-analysis published in 2018 [26].…”

Section: Main Findings and Comparison With Other Studiesmentioning

confidence: 99%

Mortality of site-specific cancer in patients with schizophrenia: A systematic review and meta-analysis

Long

Yuan

et al. 2019

Preprint

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Background: Numerous 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. Method: We 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). Results: Seven studies consisting of a total 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. Conclusions: Individuals with schizophrenia have a significantly high risk of mortality from breast, colon, and lung cancer and a high risk of mortality from prostate cancer.

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Cancer mortality in patients with schizophrenia: systematic review and meta-analysis

Cited by 70 publications

References 53 publications

Altered protein expression of galactose and N-acetylgalactosamine transferases in schizophrenia superior temporal gyrus

Altered protein expression of galactose and N-acetylgalactosamine transferases in schizophrenia superior temporal gyrus

Screening for emotional disorders in patients with cancer using the Brief Symptom Inventory (BSI) and the BSI‐18 versus a standardized psychiatric interview (the World Health Organization Composite International Diagnostic Interview)

Mortality of site-specific cancer in patients with schizophrenia: A systematic review and meta-analysis

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