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Effect of stage, comorbidities and treatment on survival among cancer patients with or without mental illness

  • Kristiina Manderbacka (a1), Martti Arffman (a1), Jaana Suvisaari (a2), Aulikki Ahlgren-Rimpiläinen (a2), Sonja Lumme (a1), Ilmo Keskimäki (a1) (a3) and Eero Pukkala (a4) (a3)...
Abstract
Background

Earlier research suggests poorer outcome of cancer care among people with severe mental illness (SMI).

 Aims

To assess the effect of stage at presentation, comorbidities and treatment on differences in survival among cancer patients with and without a history of SMI in Finland.

 Method

The total population with a first cancer diagnosis in 1990–2013 was drawn from the Finnish Cancer Registry. Hospital admissions because of SMI and deaths were obtained from administrative registers. We calculated Kaplan–Meier estimates and Cox regression models to examine survival differences.

 Results

We found excess mortality in people with a history of psychotic and substance use disorders. Cancer stage and comorbidity did not explain mortality differences. Controlling for cancer treatment decreased the differences. The mortality gap between patients with psychosis and cancer patients without SMI increased over time.

 Conclusions

Integrated medical and psychiatric care is needed to improve outcomes of cancer care among patients with SMI.
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Copyright
COPYRIGHT: © The Royal College of Psychiatrists 2017 
Corresponding author
Kristiina Manderbacka, Health and Social Systems Research, National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. Email: kristiina.manderbacka@thl.fi
Footnotes
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Declaration of Interest

None.

Footnotes
References
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  • EISSN: 1472-1465
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Effect of stage, comorbidities and treatment on survival among cancer patients with or without mental illness

  • Kristiina Manderbacka (a1), Martti Arffman (a1), Jaana Suvisaari (a2), Aulikki Ahlgren-Rimpiläinen (a2), Sonja Lumme (a1), Ilmo Keskimäki (a1) (a3) and Eero Pukkala (a4) (a3)...
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