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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

1
Department of Radiation Oncology, BC Cancer—Prince George, 1215 Lethbridge Street, Prince George, BC V2M 7E9, Canada
2
Department of Surgery, Division of Radiation Oncology and Developmental Radiotherapeutics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
3
Northern Medical Program, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada
4
Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
5
Department of Statistics, BC Cancer—Vancouver, Vancouver, BC V5Z 4E6, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(6), 4953-4960; https://doi.org/10.3390/curroncol28060415
Received: 20 October 2021 / Revised: 15 November 2021 / Accepted: 20 November 2021 / Published: 24 November 2021
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. View Full-Text
Keywords: cancer; psychiatric disorders; population-based; tobacco-related cancer cancer; psychiatric disorders; population-based; tobacco-related cancer
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MDPI and ACS Style

Olson, R.; McLay, M.; Hamm, J.; Callaghan, R.C. 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. Curr. Oncol. 2021, 28, 4953-4960. https://doi.org/10.3390/curroncol28060415

AMA Style

Olson R, McLay M, Hamm J, Callaghan RC. 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. Current Oncology. 2021; 28(6):4953-4960. https://doi.org/10.3390/curroncol28060415

Chicago/Turabian Style

Olson, Robert, Mary McLay, Jeremy Hamm, and Russell C. Callaghan 2021. "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" Current Oncology 28, no. 6: 4953-4960. https://doi.org/10.3390/curroncol28060415

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