Ten-Year Mortality after a Breast Cancer Diagnosis in Women with Severe Mental Illness: A Danish Population-Based Cohort StudyReportar como inadecuado




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Background

Breast cancer is the leading cause of cancer death in women worldwide. Nevertheless, it is unknown whether higher mortality after breast cancer contributes to the life-expectancy gap of 15 years in women with severe mental illness SMI.

Methods

We estimated all-cause mortality rate ratios MRRs of women with SMI, women with breast cancer and women with both disorders compared to women with neither disorder using data from nationwide registers in Denmark for 1980–2012.

Results

The cohort included 2.7 million women, hereof 31,421 women with SMI 12,852 deaths, 104,342 with breast cancer 52,732 deaths, and 1,106 with SMI and breast cancer 656 deaths. Compared to women with neither disorder, the mortality was 118% higher for women with SMI MRR: 2.18, 95% confidence interval CI: 2.14–2.22, 144% higher for women with breast cancer MRR: 2.44, 95% CI: 2.42–2.47 and 327% higher for women with SMI and breast cancer MRR: 4.27, 95% CI: 3.98–4.57. Among women with both disorders, 15% of deaths could be attributed to interaction. In a sub-cohort of women with breast cancer, the ten-year all-cause-mortality was 59% higher after taking tumor stage into account MRR: 1.59, 95% CI: 1.47–1.72 for women with versus without SMI.

Conclusions

The mortality among women with SMI and breast cancer was markedly increased. More information is needed to determine which factors might explain this excess mortality, such as differences between women with and without SMI in access to diagnostics, provision of care for breast cancer or physical comorbidity, health-seeking-behavior, and adherence to treatment.



Autor: Anette Riisgaard Ribe , Tinne Laurberg, Thomas Munk Laursen, Morten Charles, Peter Vedsted, Mogens Vestergaard

Fuente: http://plos.srce.hr/



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