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Are there socioeconomic differences in outcomes of coronary revascularizations--a register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature276411
Source
Eur J Public Health. 2015 Dec;25(6):984-9
Publication Type
Article
Date
Dec-2015
Author
Kristiina Manderbacka
Martti Arffman
Sonja Lumme
Ilmo Keskimäki
Source
Eur J Public Health. 2015 Dec;25(6):984-9
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Coronary Disease - epidemiology - surgery
Female
Finland - epidemiology
Healthcare Disparities - statistics & numerical data
Heart Diseases - epidemiology
Humans
Male
Middle Aged
Percutaneous Coronary Intervention - mortality - statistics & numerical data
Proportional Hazards Models
Reoperation - statistics & numerical data
Socioeconomic Factors
Treatment Outcome
Abstract
Earlier studies have reported socioeconomic differences in coronary heart disease incidence and mortality and in coronary treatment, but less is known about outcomes of care. We examined trends in income group differences in outcomes of coronary revascularizations among Finnish residents in 1998-2010.
First revascularizations for 45-84-year-old Finns were extracted from the Hospital Discharge Register in 1998-2009 and followed until 31 December 2010. Income was individually linked to them and adjusted for family size. We examined the risk of major adverse cardiac events (MACEs), coronary mortality and re-revascularization. We calculated age-standardized rates with direct method and Cox regression models.
Altogether 69 076 men and 27 498 women underwent revascularization during the study period. Among men [women] in the 1998 cohort, 41% [35%] suffered MACE during 29 days after the operation and 30% [28%] in the 2009 cohort. Myocardial infarction mortality within 1 year was 2% among both genders in both cohorts. Among men [women] 9% [14%] underwent revascularization within 1 year after the operation in 1998 and 12% [12%] in 2009. Controlling for age, co-morbidities, year, previous infarction and disease severity, an inverse income gradient was found in MACE incidence within 29 days and in coronary mortality. The excess MACE risk was 1.39 and excess mortality risk over 1.70 among both genders in the lowest income quintile. All income group differences remained stable from 1998 to 2010.
In health care, more attention should be paid to prevention of adverse outcomes among persons with low socioeconomic position undergoing revascularization.
PubMed ID
25958240 View in PubMed
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Association of Income With the Incidence Rates of First Psychiatric Hospital Admissions in Finland, 1996-2014.

https://arctichealth.org/en/permalink/ahliterature307635
Source
JAMA Psychiatry. 2020 03 01; 77(3):274-284
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-01-2020
Author
Kimmo Suokas
Anna-Maija Koivisto
Christian Hakulinen
Riittakerttu Kaltiala
Reijo Sund
Sonja Lumme
Olli Kampman
Sami Pirkola
Author Affiliation
Faculty of Social Sciences, Tampere University, Tampere, Finland.
Source
JAMA Psychiatry. 2020 03 01; 77(3):274-284
Date
03-01-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Female
Finland - epidemiology
Hospitalization - economics - statistics & numerical data
Hospitals, Psychiatric - statistics & numerical data
Humans
Incidence
Income - statistics & numerical data
Male
Mental Disorders - economics - epidemiology
Middle Aged
Multivariate Analysis
Registries
Risk factors
Young Adult
Abstract
The association between income and mental health has long been a question of interest. Nationwide register data provide means to examine trends and patterns of these associations.
To compare income-specific trends in the incidence rates of first psychiatric hospital admissions and to evaluate whether an income gradient exists in the incidence rates at all levels of household income.
This population-based open cohort study used linked registry data from nationwide Finnish Hospital Discharge and Statistics Finland population registers to determine annual incidence rates of first psychiatric hospital admissions. All Finnish citizens (N?=?6 258 033) living in the country at any time from January 1, 1996, through December 31, 2014, contributed to 96 184 614 person-years at risk of first inpatient treatment for mental disorders. The analyses were conducted from August 1, 2018, through September 30, 2019.
Equivalized disposable income, sex, age group, reduction in income decile in the previous 3 years, urbanicity, educational level, and living alone status.
Annual percentage changes in the age-standardized incidence rates and incidence rate ratios (IRRs).
Altogether, 186 082 first psychiatric inpatient treatment episodes occurred (93 431 [50.2%] men), with overall age-standardized incidence rates per 1000 person-years varying from 1.59 (95% CI, 1.56-1.63) in 2014 to 2.11 (95% CI, 2.07-2.15) in 2008. In the highest income deciles, a continuous mean decrease per year of 3.71% (95% CI, 2.82%-4.59%) in men and 0.91% (95% CI, 0.01%-1.80%) in women occurred throughout the study period, in contrast to the lowest deciles, where the trends first increased (1.31% [95% CI, 0.62%-2.01%] increase in men from 1996 to 2007 and 5.61% [95% CI, 2.36%-8.96%] increase in women from 1996 to 2001). In the adult population, an income gradient was observed at all levels of household income: the lower the income decile, the higher the adjusted IRRs compared with the highest decile. The IRRs in the lowest decile varied from 2.94 (95% CI, 2.78-3.11) to 4.46 (95% CI, 4.17-4.76). In other age groups, the gradient did not persist at the highest income deciles. Diagnosis-specific income gradient was steepest in schizophrenia and related psychotic disorders, with estimated IRRs of the lowest income decile of 5.89 (95% CI, 5.77-6.02).
In this cohort study, clear negative income gradient in the incidence rates of first hospital-treated mental disorders was observed in the adult population of Finland. These findings suggest that reduction in the use of inpatient care has not taken place equally between different income groups.
Notes
CommentIn: JAMA Psychiatry. 2020 Mar 1;77(3):233-234 PMID 31851324
PubMed ID
31851325 View in PubMed
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Both high and low levels of blood vitamin D are associated with a higher prostate cancer risk: a longitudinal, nested case-control study in the Nordic countries.

https://arctichealth.org/en/permalink/ahliterature18093
Source
Int J Cancer. 2004 Jan 1;108(1):104-8
Publication Type
Article
Date
Jan-1-2004
Author
Pentti Tuohimaa
Leena Tenkanen
Merja Ahonen
Sonja Lumme
Egil Jellum
Göran Hallmans
Pär Stattin
Sverre Harvei
Timo Hakulinen
Tapio Luostarinen
Joakim Dillner
Matti Lehtinen
Matti Hakama
Author Affiliation
Medical School, University of Tampere, Tampere, Finland. Pentti.Tuohimaa@uta.fi
Source
Int J Cancer. 2004 Jan 1;108(1):104-8
Date
Jan-1-2004
Language
English
Publication Type
Article
Keywords
Adult
Calcifediol - blood
Case-Control Studies
Finland
Humans
Longitudinal Studies
Male
Middle Aged
Norway
Prostatic Neoplasms - blood
Research Support, Non-U.S. Gov't
Risk
Sweden
Vitamin D Deficiency - complications
Abstract
Vitamin D inhibits the development and growth of prostate cancer cells. Epidemiologic results on serum vitamin D levels and prostate cancer risk have, however, been inconsistent. We conducted a longitudinal nested case-control study on Nordic men (Norway, Finland and Sweden) using serum banks of 200,000 samples. We studied serum 25(OH)-vitamin D levels of 622 prostate cancer cases and 1,451 matched controls and found that both low (/=80 nmol/l) 25(OH)-vitamin D serum concentrations are associated with higher prostate cancer risk. The normal average serum concentration of 25(OH)-vitamin D (40-60 nmol/l) comprises the lowest risk of prostate cancer. The U-shaped risk of prostate cancer might be due to similar 1,25-dihydroxyvitamin D(3) availability within the prostate: low vitamin D serum concentration apparently leads to a low tissue concentration and to weakened mitotic control of target cells, whereas a high vitamin D level might lead to vitamin D resistance through increased inactivation by enhanced expression of 24-hydroxylase. It is recommended that vitamin D deficiency be supplemented, but too high vitamin D serum level might also enhance cancer development.
Notes
Comment In: Int J Cancer. 2004 Sep 1;111(3):468; author reply 46915221979
Comment In: Int J Cancer. 2004 Sep 1;111(3):470-1; author reply 47215221981
PubMed ID
14618623 View in PubMed
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Chlamydial antibodies and risk of prostate cancer.

https://arctichealth.org/en/permalink/ahliterature17190
Source
Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):385-9
Publication Type
Article
Date
Feb-2005
Author
Tarja Anttila
Leena Tenkanen
Sonja Lumme
Maija Leinonen
Randi Elin Gislefoss
Göran Hallmans
Steinar Thoresen
Timo Hakulinen
Tapio Luostarinen
Pär Stattin
Pekka Saikku
Joakim Dillner
Matti Lehtinen
Matti Hakama
Author Affiliation
National Public Health Institute, Oulu, Finland.
Source
Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):385-9
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Adult
Antibodies, Bacterial - blood
Case-Control Studies
Chlamydia Infections - complications - diagnosis
Chlamydia trachomatis - immunology
Chlamydophila Infections - complications - diagnosis
Chlamydophila pneumoniae - immunology
Finland - epidemiology
Humans
Male
Middle Aged
Norway - epidemiology
Prostatic Neoplasms - blood - epidemiology - microbiology
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Abstract
OBJECTIVE: We assessed the risk of prostate cancer by exposure to Chlamydia trachomatis. METHOD: Seven hundred thirty eight cases of prostate cancer and 2,271 matched controls were identified from three serum sample banks in Finland, Norway, and Sweden by linkage to the population based cancer registries. RESULTS: A statistically significant inverse association (odds ratio, 0.69; 95% confidence interval, 0.51-0.94) was found. It was consistent by different serotypes and there was a consistent dose-response relationship. CONCLUSION: C. trachomatis infection is not likely to increase the risk of prostate cancer. Whether the inverse relationship is true or due to difficulties in measuring the true exposure in prostatic tissue by serology, confounders or other sources of error remain open.
PubMed ID
15734962 View in PubMed
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Circulating enterolactone and prostate cancer risk: a Nordic nested case-control study.

https://arctichealth.org/en/permalink/ahliterature19182
Source
Int J Cancer. 2002 May 1;99(1):124-9
Publication Type
Article
Date
May-1-2002
Author
Pär Stattin
Herman Adlercreutz
Leena Tenkanen
Egil Jellum
Sonja Lumme
Göran Hallmans
Sverre Harvei
Lyly Teppo
Katariina Stumpf
Tapio Luostarinen
Matti Lehtinen
Joakim Dillner
Matti Hakama
Author Affiliation
Department of Urology, Umeå University Hospital, Umeå, Sweden.
Source
Int J Cancer. 2002 May 1;99(1):124-9
Date
May-1-2002
Language
English
Publication Type
Article
Keywords
4-Butyrolactone - analogs & derivatives - blood
Case-Control Studies
Cohort Studies
Estrogens - blood
Finland - epidemiology
Fluoroimmunoassay
Humans
Lignans - blood
Male
Middle Aged
Norway - epidemiology
Prospective Studies
Prostatic Neoplasms - blood - epidemiology
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Abstract
Enterolactone, a phytoestrogen belonging to the class of lignans, is produced by the intestinal microflora from precursors in plant foods and has been implicated in protection against cancer. We study the effect of enterolactone on the risk of a subsequent diagnosis of prostate cancer. We conducted a longitudinal, nested case-control study by linkage of 3 biobanks to the cancer registries in Finland, Norway and Sweden, respectively. Enterolactone concentrations were measured by time-resolved fluoroimmunoassay in serum from 794 men who had a diagnosis of prostate cancer at a mean follow-up time of 14.2 years after blood collection and among 2,550 control men matched within each cohort for age (+/-2 years), date of blood collection (+/-2 months) and county. The median enterolactone concentrations did not differ between case and control subjects in the full study group (8.4 nmol/L [25th-75th percentile = 4.5-15.0] vs. 8.5 nmol/L [25th-75th percentile = 4.3-15.9]), nor in the national groups. Odds ratios of prostate cancer risk estimated by conditional logistic regression for increasing concentrations of enterolactone in quartiles in the full study group were 1.00 (referent), 1.21 (95% confidence interval [CI] = 0.96-1.52), 1.16 (95% CI = 0.91-1.47) and 1.08 (95% CI = 0.83-1.39). The OR estimate for the highest vs. the lowest quartile of enterolactone in separate analyses of the Norwegian, Finnish and Swedish cohort was 1.21 (95% CI = 0.91-1.60), 1.02 (95% CI = 0.59-1.76) and 0.87 (95% CI = 0.45-1.67), respectively. No support for the hypothesis that high circulating enterolactone is protective against prostate cancer was found.
PubMed ID
11948503 View in PubMed
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The contribution of health policy and care to income differences in life expectancy--a register based cohort study.

https://arctichealth.org/en/permalink/ahliterature107419
Source
BMC Public Health. 2013;13:812
Publication Type
Article
Date
2013
Author
Kristiina Manderbacka
Riina Peltonen
Sonja Lumme
Ilmo Keskimäki
Lasse Tarkiainen
Pekka Martikainen
Author Affiliation
Service System Research Unit, National Institute for Health and Welfare, P,O, Box 30, Helsinki 00271, Finland. kristiina.manderbacka@thl.fi.
Source
BMC Public Health. 2013;13:812
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Cause of Death
Cohort Studies
Delivery of Health Care - standards - trends
Female
Finland
Health Policy
Healthcare Disparities - economics - statistics & numerical data
Humans
Income
Life expectancy
Male
Middle Aged
Registries
Risk assessment
Sex Factors
Socioeconomic Factors
Abstract
Growing mortality differences between socioeconomic groups have been reported in both Finland and elsewhere. While health behaviours and other lifestyle factors are important in contributing to health differences, some researchers have suggested that some of the mortality differences attributable to lifestyle factors could be preventable by health policy measures and that health care may play a role. It has also been suggested that its role is increasing due to better results in disease prevention, improved diagnostic tools and treatment methods. This study aimed to assess the impact of mortality amenable to health policy and health care on increasing income disparities in life expectancy in 1996-2007 in Finland.
The study data were based on an 11% random sample of Finnish residents in 1988-2007 obtained from individually linked cause of death and population registries and an oversample of deaths. We examined differences in life expectancy at age 35 (e35) in Finland. We calculated e35 for periods 1996-97 and 2006-07 by income decile and gender. Differences in life expectancies and change in them between the richest and the poorest deciles were decomposed by cause of death group.
Overall, the difference in e35 between the extreme income deciles was 11.6 years among men and 4.2 years among women in 2006-07. Together, mortality amenable to health policy and care and ischaemic heart disease mortality contributed up to two thirds to socioeconomic differences. Socioeconomic differences increased from 1996-97 by 3.4 years among men and 1.7 years among women. The main contributor to changes was mortality amenable through health policy measures, mainly alcohol related mortality, but also conditions amenable through health care, ischaemic heart disease among men and other diseases contributed to the increase of the differences.
The results underline the importance of active health policy and health care measures in tackling socioeconomic health inequalities.
Notes
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PubMed ID
24010957 View in PubMed
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The effect of history of severe mental illness on mortality in colorectal cancer cases: a register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature295284
Source
Acta Oncol. 2018 Jun; 57(6):759-764
Publication Type
Journal Article
Date
Jun-2018
Author
Kristiina Manderbacka
Martti Arffman
Sonja Lumme
Jaana Suvisaari
Ilmo Keskimäki
Aulikki Ahlgren-Rimpiläinen
Nea Malila
Eero Pukkala
Author Affiliation
a Health and Social Systems Research Unit , National Institute for Health and Welfare , Helsinki , Finland.
Source
Acta Oncol. 2018 Jun; 57(6):759-764
Date
Jun-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Cohort Studies
Colorectal Neoplasms - mortality - psychology
Comorbidity
Female
Finland
Humans
Kaplan-Meier Estimate
Male
Mental Disorders - complications
Middle Aged
Proportional Hazards Models
Registries
Abstract
While the link between mental illness and cancer survival is well established, few studies have focused on colorectal cancer. We examined outcomes of colorectal cancer among persons with a history of severe mental illness (SMI).
We identified patients with their first colorectal cancer diagnosis in 1990-2013 (n?=?41,708) from the Finnish Cancer Registry, hospital admissions due to SMI preceding cancer diagnosis (n?=?2382) from the Hospital Discharge Register and deaths from the Causes of Death statistics. Cox regression models were used to study the impact on SMI to mortality differences.
We found excess colorectal cancer mortality among persons with a history of psychosis and with substance use disorder. When controlling for age, comorbidity, stage at presentation and treatment, excess mortality risk among men with a history of psychosis was 1.72 (1.46-2.04) and women 1.37 (1.20-1.57). Among men with substance use disorder, the excess risk was 1.22 (1.09-1.37).
Understanding factors contributing to excess mortality among persons with a history of psychosis or substance use requires more detailed clinical studies and studies of care processes among these vulnerable patient groups. Collaboration between patients, mental health care and oncological teams is needed to improve outcomes of care.
PubMed ID
29363989 View in PubMed
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Effect of stage, comorbidities and treatment on survival among cancer patients with or without mental illness.

https://arctichealth.org/en/permalink/ahliterature292357
Source
Br J Psychiatry. 2017 Nov; 211(5):304-309
Publication Type
Journal Article
Date
Nov-2017
Author
Kristiina Manderbacka
Martti Arffman
Jaana Suvisaari
Aulikki Ahlgren-Rimpiläinen
Sonja Lumme
Ilmo Keskimäki
Eero Pukkala
Author Affiliation
Kristiina Manderbacka, PhD, Martti Arffmar, MSc, National Institute for Health and Welfare, Health and Social Systems Research, Helsinki, Finland; Jaana Suvisaari, PhD, Aulikki Ahlgren-Rimpiläinen, PhD, National Institute for Health and Welfare, Mental Health, Helsinki, Finland; Sonja Lumme MSc, National Institute for Health and Welfare, Health and Social Systems Research, Helsinki, Finland; Ilmo Keskimäki, PhD, National Institute for Health and Welfare, Health and Social Systems Research, Helsinki, Finland and Faculty of Social Sciences, University of Tampere, Finland; Eero Pukkala, PhD, Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, and Faculty of Social Sciences, University of Tampere, Finland kristiina.manderbacka@thl.fi.
Source
Br J Psychiatry. 2017 Nov; 211(5):304-309
Date
Nov-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Comorbidity
Female
Finland - epidemiology
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Neoplasm Staging
Neoplasms - mortality - pathology - therapy
Registries
Survival Analysis
Abstract
BackgroundEarlier research suggests poorer outcome of cancer care among people with severe mental illness (SMI).AimsTo assess the effect of stage at presentation, comorbidities and treatment on differences in survival among cancer patients with and without a history of SMI in Finland.MethodThe total population with a first cancer diagnosis in 1990-2013 was drawn from the Finnish Cancer Registry. Hospital admissions because of SMI and deaths were obtained from administrative registers. We calculated Kaplan-Meier estimates and Cox regression models to examine survival differences.ResultsWe found excess mortality in people with a history of psychotic and substance use disorders. Cancer stage and comorbidity did not explain mortality differences. Controlling for cancer treatment decreased the differences. The mortality gap between patients with psychosis and cancer patients without SMI increased over time.ConclusionsIntegrated medical and psychiatric care is needed to improve outcomes of cancer care among patients with SMI.
PubMed ID
28935659 View in PubMed
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Employment Status and Personal Income Before and After Onset of a Severe Mental Disorder: A Case-Control Study.

https://arctichealth.org/en/permalink/ahliterature308184
Source
Psychiatr Serv. 2020 03 01; 71(3):250-255
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-01-2020
Author
Christian Hakulinen
Marko Elovainio
Martti Arffman
Sonja Lumme
Kimmo Suokas
Sami Pirkola
Ilmo Keskimäki
Kristiina Manderbacka
Petri Böckerman
Author Affiliation
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki (Hakulinen, Elovainio); National Institute for Health and Welfare, Helsinki (Hakulinen, Elovainio, Arffman, Lumme, Keskimäki, Manderbacka); Faculty of Social Sciences, Tampere University, Tampere, Finland (Suokas, Pirkola, Keskimäki); Pirkanmaa Hospital District, Tampere, Finland (Pirkola); School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland (Böckerman); Labour Institute for Economic Research, Helsinki (Böckerman).
Source
Psychiatr Serv. 2020 03 01; 71(3):250-255
Date
03-01-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Bipolar Disorder - economics - epidemiology
Case-Control Studies
Employment - economics - statistics & numerical data
Female
Finland - epidemiology
Humans
Income
Male
Middle Aged
Psychotic Disorders - economics - epidemiology
Schizophrenia - economics - epidemiology
Young Adult
Abstract
Individuals with severe mental disorders have an impaired ability to work and are likely to receive income transfer payments as their main source of income. However, the magnitude of this phenomenon remains unclear. Using longitudinal population cohort register data, the authors conducted a case-control study to examine the levels of employment and personal income before and after a first hospitalization for a serious mental disorder.
All individuals (N=50,551) who had been hospitalized for schizophrenia, other nonaffective psychosis, or bipolar disorder in Finland between 1988 and 2015 were identified and matched with five randomly selected participants who were the same sex and who had the same birth year and month. Employment status and earnings, income transfer payments, and total income in euros were measured annually from 1988 to 2015.
Individuals with serious mental disorders had notably low levels of employment before, and especially after, the diagnosis of a severe mental disorder. Their total income was mostly constituted of transfer payments, and this was especially true for those diagnosed as having schizophrenia. More than half of all individuals with a serious mental disorder did not have any employment earnings after they received the diagnosis.
The current study shows how most individuals in Finland depend solely on income transfer payments after an onset of a severe mental disorder.
PubMed ID
31722646 View in PubMed
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Excess mortality from breast cancer in female breast cancer patients with severe mental illness.

https://arctichealth.org/en/permalink/ahliterature307109
Source
Psychiatry Res. 2020 04; 286:112801
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-2020
Author
Aulikki J Ahlgrén-Rimpiläinen
Martti Arffman
Jaana Suvisaari
Kristiina Manderbacka
Sonja Lumme
Ilmo Keskimäki
Riikka Huovinen
Eero Pukkala
Author Affiliation
National Institute for Health and Welfare, Mental Health Unit, P.O. Box 30, Helsinki 00271, Finland. Electronic address: aulikki.ahlgren@thl.fi.
Source
Psychiatry Res. 2020 04; 286:112801
Date
04-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Breast Neoplasms - complications - mortality - psychology
Case-Control Studies
Comorbidity
Female
Finland - epidemiology
Humans
Mental Disorders - diagnosis - mortality - psychology
Middle Aged
Mood Disorders - mortality - psychology
Registries
Severity of Illness Index
Substance-Related Disorders - mortality - psychology
Abstract
Women with a history of severe mental illness (SMI) have elevated breast cancer mortality. Few studies have compared cancer-specific mortality in women with breast cancer with or without SMI to reveal gaps in breast cancer treatment outcomes. We compared breast-cancer specific mortality in women with or without SMI and investigated effects of stage at presentation, comorbidity, and differences in cancer treatment. Women with their first breast cancer diagnosis in 1990-2013 (n = 80,671) were identified from the Finnish Cancer Registry, their preceding hospital admissions due to SMI (n = 4,837) from the Hospital Discharge Register and deaths from the Causes of Death Statistics. Competing risk models were used in statistical analysis. When controlling for age, year of cancer diagnosis, and comorbidity, breast cancer mortality was significantly elevated in patients with SMI. Relative mortality was highest in breast cancer patients with non-affective psychosis, partly explained by stage at presentation. Mortality was also significantly elevated in breast cancer patients with a substance use disorder and mood disorder. Patients with SMI received radiotherapy significantly less often than patients without SMI. Our findings emphasize the need to improve early detection of breast cancer in women with SMI and the collaboration between mental health care and oncological teams.
PubMed ID
32001004 View in PubMed
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22 records – page 1 of 3.