Risk of Malignancy in Patients With Schizophrenia or Bipolar Disorder: study

	Tweet

There is conflicting evidence on whether people with schizophrenia have a different risk of cancer from that of the general population.

To determine the risk of 6 common cancers in patients with schizophrenia or bipolar disorder.

Design Population-based, nested, case-control study.

Setting A total of 454 practices contributing to the QRESEARCH general practice database.

Participants We analyzed 40 441 incident cases of 6 cancers (breast, colon, rectal, gastroesophageal, prostate, and respiratory) and up to 5 controls per case matched by single year of age, sex, general practice, and calendar time.

Main Outcome Measures Odds ratios (ORs) for cancer risk associated with schizophrenia and bipolar disorder, adjusting for smoking, body mass index, socioeconomic status, comorbidities, and prescribed medications, including antipsychotics.

Results For breast cancer, we identified 10 535/50 074 cases/controls; colon cancer, 5108/24 458; rectal cancer, 3248/15 552; gastroesophageal cancer, 3854/18 477; prostate cancer, 10 190/48 748; and respiratory cancer, 7506/35 981. After adjustment, patients with schizophrenia had a 190% increased colon cancer risk (adjusted OR, 2.90; 95% confidence interval [CI], 1.85-4.57), a marginal increased breast cancer risk (adjusted OR, 1.52; 95% CI, 1.10-2.11), and a 47% decreased respiratory cancer risk (adjusted OR, 0.53, 95% CI, 0.34-0.85). Patients with schizophrenia taking antipsychotics had a 308% increased colon cancer risk (adjusted OR, 4.08; 95% CI, 2.43-6.84). Patients with bipolar disorder had cancer risks similar to patients with neither condition after adjustment.

Conclusions Patients with schizophrenia have a significantly higher risk of colon cancer and a lower risk of respiratory cancer compared with patients without schizophrenia after adjustment for confounders. In contrast, the risks of cancer in patients with and without bipolar disorder are similar, suggesting that residual confounding is unlikely to explain the findings. The increased risk of colon cancer is particularly marked in patients with schizophrenia who take antipsychotic medications.

Author Affiliations: Division of Primary Care, University of Nottingham (Drs Hippisley-Cox and Coupland and Ms Vinogradova), and Nottingham Primary Care Research Partnership (Ms Parker), Nottingham, England.

Nested Case-Control Study

Julia Hippisley-Cox, MD; Yana Vinogradova, MSc; Carol Coupland, PhD; Chris Parker, MSc

Arch Gen Psychiatry. 2007;64(12):1368-1376.

Full article

RELATED STORIES:
Alterations in Brain’s White Matter Key to Schizophrenia   Normal role for schizophrenia risk gene identified   The Use of Depot Medications in the Treatment of Schizophrenia   Brain development goes off track as vulnerable individuals develop schizophrenia   Clozaril useful as second schizophrenia drug   Schizophrenia does not increase risk of violent crime   Altered Brain Activity in Schizophrenia May Direct Focus on Self   Effective new treatment for schizophrenia   Schizophrenia drug to be used to treat autism   Glutamate: Too much of a good thing in schizophrenia?   Brain memory finding may help schizophrenia research   No link seen between flu outbreak, schizophrenia   Why Schizophrenia Affect Men More Than Women   Depression and schizophrenia ‘should be treated with therapy’   Cognition Already Seriously Impaired in First Episode of Schizophrenia

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]