Cancer incidence and stage at diagnosis among people with recent‐onset psychotic disorders: A retrospective cohort study using health administrative data from Ontario, Canada

Objective Prior evidence on the relative risk of cancer among people with psychotic disorders is equivocal. The objective of this study was to compare incidence and stage at diagnosis of cancer for people with psychotic disorders relative to the general population. Method We constructed a retrospect...

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Bibliographic Details
Published in:Psycho-oncology (Chichester, England) England), 2022-09, Vol.31 (9), p.1510-1518
Main Authors: Wootten, Jared C., Richard, Lucie, Blanchette, Phillip S., Wiener, Joshua C., Anderson, Kelly K.
Format: Article
Language:English
Subjects:
Advanced stage
Antipsychotics
Cancer
Cohort analysis
Confounding factors
Health psychology
incidence
Medical diagnosis
Medical screening
Oncology
Patient participation
Psychosis
psychotic disorders
Risk factors
schizophrenia
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Summary:Objective Prior evidence on the relative risk of cancer among people with psychotic disorders is equivocal. The objective of this study was to compare incidence and stage at diagnosis of cancer for people with psychotic disorders relative to the general population. Method We constructed a retrospective cohort of people with a first diagnosis of non‐affective psychotic disorder and a comparison group from the general population using linked health administrative databases in Ontario, Canada. The cohort was followed for incident diagnoses of cancer over a 25‐year period. We used Poisson and logistic regression models to compare cancer incidence and stage at diagnosis between people with psychotic disorders and the comparison group, adjusting for confounding factors. Results People with psychotic disorders had an 8.6% higher incidence (IRR = 1.09, 95%CI = 1.05,1.12) of cancer overall relative to the comparison group, with effect modification by sex and substantial variation across cancer sites. People with psychotic disorders also had 23% greater odds (OR = 1.23, 95%CI = 1.13,1.34) of being diagnosed with more advanced stage cancer relative to the comparison group. Conclusions We found evidence of elevated cancer incidence in people with non‐affective psychotic disorders relative to the general population. The higher odds of more advanced stage cancer diagnoses in people with psychotic disorders represents an opportunity to improve patient participation in recommended cancer screening, as well as timely access to services for cancer diagnosis and treatment. Future research should examine confounding effects of lifestyle factors and antipsychotic medications on the risk of developing cancer among people with psychotic disorders.
ISSN:1057-9249
1099-1611
DOI:10.1002/pon.5983