Inverse association between cancer risks and age in schizophrenic patients: A 12‐year nationwide cohort study

Cancer Science - Tập 104 Số 3 - Trang 383-390 - 2013
Chun‐Yuan Lin1,2,3, Hsien‐Yuan Lane4,2, T.L. Chen5, Yu‐Hsin Wu3, Chun‐Ying Wu6,7,8,5, Vivian Y. Wu9
1Department of Psychiatry, Changhua Hospital, Changhua, Taiwan
2Institute of Clinical Medical Science, Medical College, China Medical University, Taichung, Taiwan
3National Changhua University of Education, Changhua, Taiwan
4Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
5Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
6Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan
7Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
8Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan
9Sol Price School of Public Policy, University of Southern California, Los Angeles, California, USA

Tóm tắt

The association between schizophrenia and cancer risk is contentious in the clinical and epidemiological literature. Studies from different populations, tumor sites, or health care systems have provided inconsistent findings. In the present study, we examined a less well‐investigated hypothesis that age plays a crucial role in cancer risk in schizophrenia. We conducted a nationwide cohort study using Taiwan's National Health Insurance Research Database (NHIRD) between 1995 and 2007. Overall, gender‐, and age‐stratified standardized incidence ratios (SIR) were used to investigate the pattern of cancer risk by age. Of the 102 202 schizophrenic patients, 1738 developed cancer after a diagnosis of schizophrenia (SIR = 0.92; 95% confidence interval [CI] 0.90–0.96). However, the age‐stratified SIR declined with age (e.g. SIR [95% CI] = 1.97 [1.85–2.33], 0.68 [0.65–0.78], and 0.36 [0.34–0.45] for those aged 20–29, 60–69, and ≥70 years, respectively) in both genders and for major cancers. Cancer risks in schizophrenic patients were lower for cancers that are more likely to develop at an older age in the general population (e.g. stomach cancer [SIR = 0.62; 95% CI 0.57–0.80], pancreatic cancer [SIR = 0.49; 95% CI 0.39–0.84], and prostate cancer [SIR = 0.35; 95% CI 0.29–0.58]). In contrast, cancer risks were higher for cancers that have a younger age of onset, such as cancers of the nasopharynx (SIR = 1.18; 95% CI 1.08–1.49), breast (SIR = 1.50; 95% CI 1.44–1.66) and uterine corpus (SIR = 2.15; 95% CI 1.98–2.74). The unique age structures and early aging potential of schizophrenia populations may contribute to the observed inverse relationship between age and cancer risk. Higher cancer comorbidity in young schizophrenic patients deserves more attention.

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Cancer Science

Tập 104 Số 3

383-390

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