Excess Cancer Mortality in Psychiatric Patients

Abstract

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 in communication or access to health care.

Causes of Mortality in Schizophrenia: An Updated Review of European Studies

“…This is confirmed by a disproportion in mortality from cardiac infarction or cancer in schizophrenia patients and in people without such diagnosis, unfavourable for the former, despite similar prevalence of these disorders (Kisely et al 2008, Hodgson et al 2010, Crump et al 2013). Furthermore, in people who died due to above causes, these disorders were significantly less often diagnosed in schizophrenia patients during their life, and this may indicate lower availability of screening tests and modern diagnostic methods.…”

The Epidemiology of Excess Mortality in People with Mental Illness

“…89 In the case of cancer, the incidence at some sites for psychiatric patients is no higher than that of the general population, although mortality is higher. 21,22 It is unlikely that lifestyle explains this finding, otherwise incidence should better reflect the increased mortality rate. Although there are less data for other conditions such as cardiovascular disease, these disorders share similar risk factors including tobacco, diet, and alcohol.…”

The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults

“…For individuals with serious mental illness, the reduction is even more dramatic: up to 25 years (Parks et al 2006;Saha et al 2007). Individuals with mental illness have increased cardiovascular mortality (Miller et al 2006;Morden et al 2012;Newcomer and Hennekens 2007;Osborn et al 2007;Parks et al 2006;Piatt et al 2010; Roshanaei-Moghaddam and Katon 2009), greater incidence of medical conditions (Dickerson et al 2006a;Kisely et al 2008;Leucht et al 2007;McGinty et al 2012;Osborn et al 2007), greater risk of injury (McGinty et al 2013;Piatt et al 2010), and greater rates of health risk factors such as obesity and tobacco use (Dickerson et al 2006b;Lawrence et al 2009;Osborn et al 2006). Dental health is also poorer in those with severe mental illness (Kisely et al 2011;Leucht et al 2007) and can contribute to health risks such as community acquired pneumonia and endocarditis.…”