Analyzing excess mortality from cancer among individuals with mental illness

BACKGROUND The objective was to compare patterns of site‐specific cancer mortality in a population of individuals with and without mental illness. METHODS This was a cross‐sectional, population‐based study using a linked data set comprised of death certificate data for the state of Ohio for the year...

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Bibliographic Details
Published in:Cancer Vol. 119; no. 13; pp. 2469 - 2476
Main Authors: Musuuza, Jackson S., Sherman, Marion E., Knudsen, Kraig J., Sweeney, Helen Anne, Tyler, Carl V., Koroukian, Siran M.
Format: Journal Article
Language:English
Published: Hoboken, NJ Wiley-Blackwell 01.07.2013
Subjects:
Adolescent
Adult
Aged
all‐cancer mortality
Biological and medical sciences
Black or African American - statistics & numerical data
Child
Child, Preschool
Cross-Sectional Studies
Epidemiology
excess mortality
Female
Hepatitis, Chronic - diagnosis
Hepatitis, Chronic - therapy
Humans
Infant
Male
Mass Screening
Medical sciences
Mental Disorders - complications
Mental Disorders - epidemiology
mental illness
Middle Aged
Neoplasms - complications
Neoplasms - etiology
Neoplasms - mortality
Ohio - epidemiology
Risk Factors
site‐specific cancer mortality
Smoking Cessation
Substance-Related Disorders - prevention & control
Substance-Related Disorders - therapy
Tumors
United States
North America
America
Ohio
Human
mental illness
Mortality
Mental health
excess mortality
all-cancer mortality
site-specific cancer mortality
Malignant tumor
Epidemiology
Site specificity
Cancerology
Cross sectional study
Mental disorder
Public health
Cancer
ISSN:0008-543X, 1097-0142, 1097-0142
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Summary:BACKGROUND The objective was to compare patterns of site‐specific cancer mortality in a population of individuals with and without mental illness. METHODS This was a cross‐sectional, population‐based study using a linked data set comprised of death certificate data for the state of Ohio for the years 2004‐2007 and data from the publicly funded mental health system in Ohio. Decedents with mental illness were those identified concomitantly in both data sets. We used age‐adjusted standardized mortality ratios (SMRs) in race‐ and sex‐specific person‐year strata to estimate excess deaths for each of the anatomic cancer sites. RESULTS Overall, there was excess mortality from cancer associated with having mental illness in all the race/sex strata: SMR, 2.16 (95% CI, 1.85‐2.50) for black men; 2.63 (2.31‐2.98) for black women; 3.89 (3.61‐4.19) for nonblack men; and 3.34 (3.13‐3.57) for nonblack women. In all the race/sex strata except for black women, the highest SMR was observed for laryngeal cancer, 3.94 (1.45‐8.75) in black men and 6.51 (3.86‐10.35) and 6.87 (3.01‐13.60) in nonblack men and women, respectively. The next highest SMRs were noted for hepatobiliary cancer and cancer of the urinary tract in all race/sex strata, except for black men. CONCLUSIONS Compared with the general population in Ohio, individuals with mental illness experienced excess mortality from most cancers, possibly explained by a higher prevalence of smoking, substance abuse, and chronic hepatitis B or C infections in individuals with mental illness. Excess mortality could also reflect late‐stage diagnosis and receipt of inadequate treatment. Cancer 2013;119:2469‐2476. © 2013 American Cancer Society. Compared with the general population in Ohio, individuals with mental illness experienced excess mortality from cancers, possibly explained by a higher prevalence of smoking, substance abuse, and chronic hepatitis B or C infections in individuals with mental illness, but also by hindered access to care.
Bibliography:The results were presented in part at the American Society of Clinical Oncology annual meeting in Chicago, Illinois, July 2012.
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ISSN:0008-543X
1097-0142
1097-0142
DOI:10.1002/cncr.28091