Excess mortality from breast cancer in female breast cancer patients with severe mental illness
Autor: | Riikka Huovinen, Jaana Suvisaari, Kristiina Manderbacka, Sonja Lumme, Eero Pukkala, Aulikki Ahlgrén-Rimpiläinen, Ilmo Keskimäki, Martti Arffman |
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Rok vydání: | 2020 |
Předmět: |
Adult
medicine.medical_specialty Substance-Related Disorders medicine.medical_treatment education Breast Neoplasms Comorbidity Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine mental disorders medicine Humans Registries skin and connective tissue diseases Finland Biological Psychiatry Mood Disorders business.industry Mental Disorders fungi Cancer Middle Aged medicine.disease Mental illness 030227 psychiatry Cancer registry Substance abuse Radiation therapy Psychiatry and Mental health Mood Case-Control Studies Female business 030217 neurology & neurosurgery |
Zdroj: | Psychiatry Research. 286:112801 |
ISSN: | 0165-1781 |
DOI: | 10.1016/j.psychres.2020.112801 |
Popis: | Women with a history of severe mental illness (SMI) have elevated breast cancer mortality. Few studies have compared cancer-specific mortality in women with breast cancer with or without SMI to reveal gaps in breast cancer treatment outcomes. We compared breast-cancer specific mortality in women with or without SMI and investigated effects of stage at presentation, comorbidity, and differences in cancer treatment. Women with their first breast cancer diagnosis in 1990–2013 (n = 80,671) were identified from the Finnish Cancer Registry, their preceding hospital admissions due to SMI (n = 4,837) from the Hospital Discharge Register and deaths from the Causes of Death Statistics. Competing risk models were used in statistical analysis. When controlling for age, year of cancer diagnosis, and comorbidity, breast cancer mortality was significantly elevated in patients with SMI. Relative mortality was highest in breast cancer patients with non-affective psychosis, partly explained by stage at presentation. Mortality was also significantly elevated in breast cancer patients with a substance use disorder and mood disorder. Patients with SMI received radiotherapy significantly less often than patients without SMI. Our findings emphasize the need to improve early detection of breast cancer in women with SMI and the collaboration between mental health care and oncological teams. |
Databáze: | OpenAIRE |
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