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Cancer More Likely to Occur In Patients With Severe Mental Illness

TOP - Daily

New research from Johns Hopkins raises questions about whether patients burdened with serious mental illness are receiving appropriate cancer screenings and preventive care related to risk factors for cancer.

The study’s findings, published in the journal Psychiatric Services, suggest that people with serious mental illness (schizophrenia, bipolar disorder, and disabling depression) are 2.6 times more likely to develop cancer than the general population.

“The increased risk is definitely there, but we’re not entirely sure why,” says study leader Gail L. Daumit, MD, MHS, an associate professor of medicine and psychiatry at the Johns Hopkins University School of Medicine. She speculates that this population is “falling through the cracks.”

Daumit’s team looked at data from 3317 Maryland Medicaid beneficiaries with an average age between 42 and 43 years. Researchers sought to determine whether these patients diagnosed with schizophrenia and bipolar disorder developed cancer between 1994 and 2004, and what type of cancer they had. They discovered that patients with schizophrenia, when compared with the general population, were more than 4.5 times more likely to develop lung cancer, 3.5 times more likely to develop colorectal cancer, and nearly 3 times more likely to develop breast cancer. Patients with bipolar disorder experienced similarly high risk for lung, colorectal, and breast cancer. There were no racial differences in who developed cancer in this group.

Daumit says smoking, which is more prevalent in people with serious mental illnesses, could be causing the elevated risk of lung cancer for this population. She also thinks that the breast cancer risk could be related to the fact that women with schizophrenia and bipolar disorder are less likely to have children, and childbearing is believed to reduce breast cancer risk. Another factor previously linked to breast cancer is the hormone prolactin, and some psychotropic medications can increase levels of that hormone. The colorectal cancer risk, she says, could be due to lifestyle issues, including smoking, lack of physical activity, and a diet without fruits and vegetables.

Daumit says more study is needed on the role of behavioral and pharmacological factors in increased cancer risk among people with serious mental illness. Studying the extent to which this population receives appropriate cancer screening and treatment would be beneficial also.

Source: Johns Hopkins.