CLINICAL CONTEXT
Adults with serious and persistent mental illness such as schizophrenia and bipolar disorder experience a higher risk for premature mortality vs individuals without these mental illnesses, and a previous study by Piatt and colleagues analyzed the potential causes of early death among adults with serious mental illness. Their research, which was published in the July 2010 issue of Psychiatric Services, found that a higher rate of accidents and suicide had the biggest impacts on increasing the risk for mortality among individuals with serious mental illness. Other important causes of death specifically among adults with serious mental illness were liver disease and septicemia.
Cancer also promoted a higher risk for early mortality among adults with serious mental illness, but not all research has supported a higher risk for cancer among individuals with schizophrenia and bipolar disorder. The current study by Daumit and colleagues evaluates the cancer risk associated with serious mental illness.
STUDY HIGHLIGHTS
The investigators conducted their research as a retrospective study of adult beneficiaries of Medicaid in Maryland. All study participants were between 21 and 62 years old and had either a diagnosis of schizophrenia or bipolar disorder with disability.
The main study outcome was incident cancer, which was determined from Medicaid claims data. The data from individuals with serious mental illness were compared vs national norms from the Surveillance Epidemiology and End Results program.
The study cohort included 2315 adults with schizophrenia and 1002 individuals with bipolar disorder. The mean age of study patients was approximately 42 years, and there was a slight preponderance of women in the overall cohort. The study was fairly evenly divided among African American and white participants.
Overall, the total cancer incidence was 2.6 times higher among adults with serious mental illness vs adults without serious mental illness.
Both schizophrenia and bipolar disorder were associated with a significantly increased risk for cancer.
The risk for lung cancer was 4 times higher among adults with serious mental illness, and the risk for colorectal cancer was similarly elevated.
The risk for breast cancer was elevated to a slightly greater extent among women with schizophrenia vs women with bipolar disorder.
Serious mental illness was not associated with a higher risk for prostate cancer.
Patients’ race did not affect the higher risk for cancer associated with serious mental illness.
CLINICAL IMPLICATIONS
Previous research by Piatt and colleagues has demonstrated that accidents and suicide are the most important causes of early death among individuals with serious mental illness vs adults without serious mental illness.
In the current study by Daumit and colleagues, schizophrenia and bipolar disorder were associated with an overall higher risk for cancer, including lung, colorectal, and breast cancers.
INDIAN CLINICAL KNOWLEDGE 