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.
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.