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Schizophrenia and cancer: an epidemiological study

  • Michael J. Goldacre (a1), Lianne M. Kurina (a2), Clare J. Wotton (a1), David Yeates (a1) and Valerie Seagroatt (a1)...
Abstract
Background

For decades there has been interest in the possibility that people with schizophrenia might have some protection against cancer, and that, if this were so, it might hold clues about aetiological mechanisms in schizophrenia.

Aims

To study cancer incidence in schizophrenia.

Method

Cohort analysis of linked hospital and death records was used to compare cancer rates in people with schizophrenia with a reference cohort.

Results

We did not find a reduced risk for cancer overall (rate ratio 0.99, 95% CI 0.90–1.08) or for most individual cancers. There was, however, a significantly low rate ratio for skin cancer (0.56, 95% CI 0.36–0.83)

Conclusions

We found no evidence that schizophrenia confers protection against cancer in general. Low rates of skin cancer are consistent with the hypothesis that sun exposure may influence the development of schizophrenia, although other explanations are also possible.

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Copyright
Corresponding author
Professor Michael J. Goldacre, Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road Campus, Old Road, Oxford OX3 7LF, UK, Tel: +44(0)1865 226994; fax: +44(0)1865 226993; e-mail: michael.goldacre@dphpc.ox.ac.uk
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Declaration of interest

None.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Schizophrenia and cancer: an epidemiological study

  • Michael J. Goldacre (a1), Lianne M. Kurina (a2), Clare J. Wotton (a1), David Yeates (a1) and Valerie Seagroatt (a1)...
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eLetters

Schizophrenia and skin cancer

David M. Lawrence
Statistician
21 August 2008

It has only just come to my attention that in their article Goldacre et al suggest that as my colleagues and I have access to a large population linked database we could illuminate their findings. They reported no difference in cancer incidence rates between people with schizophrenia and the general population except for skin cancer where theyobserved an adjusted rate ratio for malignant melanoma of 0.2 (95% CI: 0.02 - 0.74), and wondered if we could calculate similar figures. In fact, we published these figures in 2001 [1] and reported no difference inincidence of malignant melanoma between people with schizophrenia and the general population (RR of 0.76 (0.42-1.38) for males and 0.93 (0.50-1.71) for females). Given that Goldacre et al's conclusion was based on 2 observed melanomas when 9.7 were expected, and they performed tests for 33cancer sites and found only one significant difference while not making any adjustment for multiple testing, our view remains that there is no difference in cancer incidence between people with schizophrenia and the general population, although case fatality seems worse.

[1] Lawrence D, Holman CDJ, Jablensky AV (2001). Duty to Care. Preventable physical illness in people with mental illness. Perth: University of Western Australia.
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