Cancer in patients with schizophrenia: What is the next step?

Psychiatry Clin Neurosci. 2016 Nov;70(11):473-488. doi: 10.1111/pcn.12420. Epub 2016 Aug 14.

Abstract

People with schizophrenia, who constitute approximately 0.3-1% of the general population, have a nearly 20% shorter life expectancy than the general population. The incidence of varied types of cancers in patients with schizophrenia is controversial. The majority of previous research has demonstrated that patients who have schizophrenia and cancer have early mortality compared to the general population with cancer. The causes of early mortality in patients with schizophrenia and cancer might be attributed to a lower cancer screening rate and lack of effective treatment, including: (i) patient factors, such as poor lifestyle, passive attitude toward treatment, or comorbidity; (ii) physician factors, such as physician bias, which may decrease the delivery of care for individuals with mental disorders; and (iii) hospital administration factors, such as stigma and discrimination. Additional studies on patients with schizophrenia and cancer are warranted and should include the following: a comprehensive review of previous studies; a focus on differentiating the specific types of cancer; and methods for improvement. To decrease the early mortality of patients with schizophrenia, the following measures are proposed: (i) enhance early detection and early treatment, such as increasing the cancer screening rate for patients with schizophrenia; (ii) provide effective, timely treatment and rehabilitation; (iii) improve patients' psychiatric symptoms and cognitive impairment; (iv) promote healthy behavior in the general population and emphasize healthy lifestyles in vulnerable populations; and (v) remove the stigma of schizophrenia. To reduce disparities in physical health, public health strategies and welfare policies must continue to focus on this group of patients.

Keywords: cancer; incidence; mortality; schizophrenia; stigma.

Publication types

  • Review

MeSH terms

  • Comorbidity*
  • Humans
  • Neoplasms / epidemiology*
  • Neoplasms / mortality
  • Neoplasms / prevention & control
  • Schizophrenia / epidemiology*
  • Schizophrenia / mortality
  • Schizophrenia / prevention & control