Adult urologyProstate cancer and schizophrenia
Section snippets
Material and methods
A literature search of “prostate cancer” or “cancer” and “schizophrenia” was done using MEDLINE. Five studies were identified that provided specific data on the incidence of prostate cancer in men with schizophrenia2, 3, 4, 5, 6; five other studies did not provide cancer data by site, included cases that duplicated previous studies, or merely summarized previously published data.7, 8, 9, 10, 11 Four of the five studies with usable data were performed in Scandinavian countries or Israel, where
Results
The observed and expected numbers of cases of prostate cancer for the five studies are listed in Table I. In all five studies, the standardized incidence ratio for prostate cancer in individuals with schizophrenia was lower than expected, ranging from 0.49 to 0.76.
The overall cancer rate in the five studies varied. In two studies, it was decreased2, 5; in one, it was decreased in men but not in women6; in one, it was neither decreased nor increased4; and in one, it was increased, especially for
Comment
The incidence of prostate cancer in men with schizophrenia is between one half and three quarters of what is expected. As such, the incidence of prostate cancer is similar to that of rheumatoid arthritis, which, in multiple studies, has been reported to have a decreased incidence in those with schizophrenia.12
Several explanations must be considered for this decreased incidence. An ascertainment bias is possible, because individuals with schizophrenia are known to receive inferior medical care,
Conclusions
The results of this study have shown that the incidence of prostate cancer in men with schizophrenia is significantly lower than expected. A cancer-protective effect of antipsychotic medications, genetic factors, and lifestyle differences may be involved. Regarding the first, in vitro studies of antipsychotic medication on prostate cancer cells should be done to ascertain whether these medications are protective. The low incidence of prostate cancer in men with schizophrenia takes its place
References (20)
- et al.
Cancer in schizophrenia: is the risk higher or lower?
Schizophr Res
(2005) - et al.
Risk for cancer in a cohort of patients hospitalized for schizophrenia in Denmark, 1969–1993
Schizophr Res
(2005) - et al.
The association between schizophrenia and cancer: a population-based mortality study
Schizophr Res
(2002) - et al.
The schizophrenia–rheumatoid arthritis connection: infectious, immune, or both?
Brain Behav Immun
(2001) Chlorpromazines and cancer
Lancet
(1972)- et al.
Effects of psychotropic drugs on cell proliferation and differentiation
Biochem Pharmacol
(1999) - et al.
Differences in p53 gene polymorphisms between Korean schizophrenia and lung cancer patients
Schizophr Res
(2004) Cancer death risk in hospitalized mental patients
Science
(1978)The incidence of cancer in schizophrenic patients
J Epidemiol Commun Health
(1989)- et al.
Incidence of cancer among persons with schizophrenia and their relatives
Arch Gen Psychiatry
(2001)