Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2013 Jul 1;119(13):2469-76.
doi: 10.1002/cncr.28091. Epub 2013 Apr 12.

Analyzing excess mortality from cancer among individuals with mental illness

Jackson S Musuuza  1 , Marion E Sherman, Kraig J Knudsen, Helen Anne Sweeney, Carl V Tyler, Siran M Koroukian
Affiliations
Comparative Study

Analyzing excess mortality from cancer among individuals with mental illness

Jackson S Musuuza et al. Cancer. .

Abstract

Background: The objective was to compare patterns of site-specific cancer mortality in a population of individuals with and without mental illness.

Methods: This was a cross-sectional, population-based study using a linked data set comprised of death certificate data for the state of Ohio for the years 2004-2007 and data from the publicly funded mental health system in Ohio. Decedents with mental illness were those identified concomitantly in both data sets. We used age-adjusted standardized mortality ratios (SMRs) in race- and sex-specific person-year strata to estimate excess deaths for each of the anatomic cancer sites.

Results: Overall, there was excess mortality from cancer associated with having mental illness in all the race/sex strata: SMR, 2.16 (95% CI, 1.85-2.50) for black men; 2.63 (2.31-2.98) for black women; 3.89 (3.61-4.19) for nonblack men; and 3.34 (3.13-3.57) for nonblack women. In all the race/sex strata except for black women, the highest SMR was observed for laryngeal cancer, 3.94 (1.45-8.75) in black men and 6.51 (3.86-10.35) and 6.87 (3.01-13.60) in nonblack men and women, respectively. The next highest SMRs were noted for hepatobiliary cancer and cancer of the urinary tract in all race/sex strata, except for black men.

Conclusions: Compared with the general population in Ohio, individuals with mental illness experienced excess mortality from most cancers, possibly explained by a higher prevalence of smoking, substance abuse, and chronic hepatitis B or C infections in individuals with mental illness. Excess mortality could also reflect late-stage diagnosis and receipt of inadequate treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Age-Adjusted Standardized Mortality Rates (SMR) by race/sex categories Footnote for Figures 1A–D: - The number in parentheses indicates the observed number of observed deaths in that race/sex stratum, and for that cancer site. - White bars are for SMRs that were not statistically significant at p < 0.05. All remaining SMRs were significant at p < 0.05.
Figure 1
Figure 1
Age-Adjusted Standardized Mortality Rates (SMR) by race/sex categories Footnote for Figures 1A–D: - The number in parentheses indicates the observed number of observed deaths in that race/sex stratum, and for that cancer site. - White bars are for SMRs that were not statistically significant at p < 0.05. All remaining SMRs were significant at p < 0.05.
Figure 1
Figure 1
Age-Adjusted Standardized Mortality Rates (SMR) by race/sex categories Footnote for Figures 1A–D: - The number in parentheses indicates the observed number of observed deaths in that race/sex stratum, and for that cancer site. - White bars are for SMRs that were not statistically significant at p < 0.05. All remaining SMRs were significant at p < 0.05.
Figure 1
Figure 1
Age-Adjusted Standardized Mortality Rates (SMR) by race/sex categories Footnote for Figures 1A–D: - The number in parentheses indicates the observed number of observed deaths in that race/sex stratum, and for that cancer site. - White bars are for SMRs that were not statistically significant at p < 0.05. All remaining SMRs were significant at p < 0.05.
See this image and copyright information in PMC

References

    1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):593–602. - PubMed
    1. Phillips Physical disorder in 164 consecutive admissions to a mental hospital:the incidence and significance. BMJ. 1934;2:363–6. - PMC - PubMed
    1. Kamara SG, Peterson PD, Dennis JL. Prevalence of physical illness among psychiatric inpatients who die of natural causes. Psychiatr Serv. 1998 Jun;49(6):788–93. - PubMed
    1. Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis. 2006 Apr;3(2):A42. - PMC - PubMed
    1. Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry. 2007 Oct;64(10):1123–31. - PubMed

Publication types

MeSH terms