Identification of Tobacco-Related Cancer Diagnoses among Individuals with Psychiatric Disorders: A Population-Based Matched Cohort Study Using a Competing Risks Approach from British Columbia
| Autor: | Jeremy Hamm, Russell C. Callaghan, Mary McLay, Robert Olson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Population Lower risk Article Cohort Studies Neoplasms Tobacco medicine Humans cancer Bipolar disorder education Psychiatry Depression (differential diagnoses) RC254-282 education.field_of_study British Columbia business.industry Incidence (epidemiology) Mental Disorders Neoplasms. Tumors. Oncology. Including cancer and carcinogens tobacco-related cancer medicine.disease psychiatric disorders population-based Cancer registry Cohort Anxiety medicine.symptom business |
| Zdroj: | Current Oncology; Volume 28; Issue 6; Pages: 4953-4960 Current Oncology, Vol 28, Iss 415, Pp 4953-4960 (2021) Current Oncology |
| ISSN: | 1718-7729 |
| DOI: | 10.3390/curroncol28060415 |
| Popis: | Background: Individuals with psychiatric disorders (PD) have a high prevalence of tobacco use. Therefore, we assessed the hazard of receiving a tobacco-related (TR) cancer diagnosis among individuals with PD. Methods: Several population-based provincial databases were used to identify individuals in BC diagnosed with depression, schizophrenia, bipolar disorder, anxiety disorders, or multiple PD between 1990 and 2013. A primary population proxy comparison group (appendicitis) was also identified and matched to the psychiatric cohort based on age at cohort entry, gender, year of cohort entry, and postal code. We linked individuals in the cohort and comparison groups with the BC Cancer Registry. Using a competing risks approach, we estimated the effect of having a PD on the risk of receiving a TR cancer diagnosis, in light of the competing risk of mortality. Results: In total, 165,289 patients were included. Individuals with depression (HR = 0.81; p < 0.01; 95% CI: 0.73–0.91), anxiety disorders (HR = 0.84; p = 0.02; 95% CI: 0.73–0.97), or multiple PD (HR = 0.74; p < 0.01; 95% CI: 0.66–0.83) had a statistically significant lower risk of a TR cancer diagnosis compared to the comparison group. Individuals with schizophrenia (HR = 0.86; p = 0.40; 95% CI: 0.62–1.21) or bipolar disorder (HR = 0.58; p = 0.12; 95% CI: 0.29–1.14), however, showed no evidence of a statistically significant difference from the comparison group. Interpretation: We found that individuals with depression, anxiety disorders, or multiple PD diagnoses had a significantly reduced risk of receiving a tobacco-related cancer diagnosis. These results were unexpected and could be explained by individuals with a PD having barriers to a cancer diagnosis rather than a true decreased incidence. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|