Risk of Malignancy in Patients With Schizophrenia or Bipolar Disorder

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Abstract
For almost 100 years, there has been speculation that patients with schizophrenia have lower cancer risks than the general population. In 1909, this possibility was raised by the Board of Control of the Commissioners in Lunacy for England and Wales,1 but a century later the evidence is still far from clear. Whereas some studies have suggested a lower cancer incidence or mortality rate in people with schizophrenia,2-7 others have found either an increased cancer incidence8 or mortality9 associated with schizophrenia or nonsignificant effects.10,11 Existing studies have been limited by size, use of biased populations (such as hospital-based cohorts), and lack of ability to control for potential confounding effects. Failure to adjust for these factors is extremely important given that patients with mental health problems have a higher prevalence of common risk factors, including smoking, alcohol consumption, and obesity12,13; they are also less likely to report physical symptoms or to adhere to treatment regimens.14,15