Cancer incidence in young and middle-aged people with schizophrenia: Nationwide cohort study in Taiwan, 2000–2010

Abstract

Aims

The relationship between cancer and schizophrenia requires re-examination. We investigated the cancer risk among young and middle-aged patients with schizophrenia.

Methods

Records of newly admitted patients with schizophrenia (n = 32.731) from January 2000 through December 2008 were retrieved from the Psychiatric Inpatient Medical Claims database in Taiwan, and the first psychiatric admission of each patient during the same period was defined as the baseline. Five hundred and fourteen incident cancer cases were identified and standardized incidence ratios (SIRs) were calculated to compare the risk of cancer between those with schizophrenia and the general population. Stratified analyses of cancer incidences were performed by gender, site of cancers, and duration since baseline.

Results

The incidence of cancer for all sites was slightly higher than that of the general population for the period (SIR = 1.15 [95% CI 1.06–1.26], P = 001). Men had a significantly higher incidence of colorectal cancer (SIR = 1.48 [95% CI 1.06–2.06], P = 0.019). Women had a higher incidence of breast cancer (SIR = 1.47 [95% CI 1.22–1.78], P < .001). Intriguingly, the risk for colorectal cancer was more pronounced 5 years after the first psychiatric admission rather than earlier (SIR = 1.94 [1.36–2.75], P < .001), and so was the risk for breast cancer (SIR = 1.85 [1.38–2.48], P < .001). The cancer incidence was higher in schizophrenic patients contradicting the belief that schizophrenia was protective of cancers.

Conclusions

Men and women with schizophrenia were more vulnerable to certain types of cancers, which indicate the need for gender-specific cancer screening programs.

Disclosure of interest

The author has not supplied his declaration of competing interest.