REVIEW ARTICLE


The Risk and The Course of Cancer Among People with Severe Mental Illness



Luigi Grassi1, *, Daniel McFarland2, Michelle Riba3, 4
1 Department of Neuroscience and Rehabilitation, DInstitute of Psychiatry, University of Ferrara and University Hospital Psychiatric Unit, Ferrara, Italy
2 Department of Medicine, Hofstra University, Northwell Health, Lenox Hill Hospital, New York, NY, US
3 Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
4 Psycho-oncology Program, University of Michigan Depression Center and Rogel Cancer Center, Ann Arbor, MI, USA


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Creative Commons License
© 2023 Grassi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Neuroscience and Rehabilitation, DInstitute of Psychiatry, University of Ferrara and University Hospital Psychiatric Unit, Ferrara, Italy; Tel: +39 0532 236409;
Fax: +39 0532 212240; E-mail: luigi.grassi@unife.it


Abstract

The paucity of data regarding patients with Serious Mental Illness (SMI) and cancer is alarming given the fact that people with SMI, especially schizophrenia, bipolar disorders and severe depressive disorders, have in general poorer access to physical health care and higher morbidity and mortality because of physical illnesses. The aims of this review were to examine the current evidence from existing literature on the risk of developing cancer and its course among people with SMI. Equivocal results emerge regarding the risk of developing some kind of cancer among people with SMI, with contrasting data on a possible higher, similar or lower risk in comparison with the general population. In contrast, a series of studies have pointed out that patients with SMI who develop cancer are less likely to receive standard levels of cancer care, both in terms of screening, diagnosis and treatment. Also, the mortality for cancer has been confirmed to be higher than the general population. A global sensitization about these problems is mandatory in an era in which community psychiatry has been developed in all countries and that policies of prevention, treatment, follow up, and palliative care should regard all the segments of the population, including people with SMI, through an interdisciplinary approach.

Keywords: Cancer, Incidence, Course, Schizophrenia, Bipolar disorders, Depression.