Cancer staging in individuals with a severe psychiatric illness: a cross-sectional study using population-based cancer registry data

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dc.contributor.author Mahar, Alyson L
dc.contributor.author Kurdyak, Paul
dc.contributor.author Hanna, Timothy P
dc.contributor.author Coburn, Natalie G
dc.contributor.author Groome, Patti A
dc.date.accessioned 2020-06-01T03:16:29Z
dc.date.issued 2020-05-27
dc.identifier.citation BMC Cancer. 2020 May 27;20(1):476
dc.identifier.uri https://doi.org/10.1186/s12885-020-06943-w
dc.identifier.uri http://hdl.handle.net/1993/34691
dc.description.abstract Abstract Background Advanced cancer stage at diagnosis may explain high cancer mortality among patients with a severe psychiatric illness (SPI). Studies to date investigating advanced stage cancer at diagnosis as a potential explanation for high cancer mortality in individuals with a history of mental illness have been inconclusive. We examined the relationship between a SPI history and unknown cancer stage at diagnosis in colorectal cancer (CRC) patients. Methods This was a population-based, cross-sectional study using linked administrative databases of CRC patients diagnosed between 01/04/2007 and 31/12/2012. Individuals who had a history of mental illness but did not meet the definition of a SPI were excluded. An SPI was measured in the 5 years prior to the cancer diagnosis and categorized as inpatient, outpatient or no SPI. Individuals with a best stage in Stage 0 to Stage IV were considered staged and absence of staging information was defined as unknown stage. The risk of unknown stage cancer was estimated using modified Poisson regression. Results The final study cohort included 24,507 CRC patients. 258 (1.1%) individuals experienced a history of inpatient SPI and 482 (2.0%) experienced outpatient SPI. After adjusting for confounders, CRC patients with an inpatient or outpatient history of SPI were at greater risk of having missing TNM stage at diagnosis, compared to patients with no history of a mental illness (RR 1.45 (95% CI: 1.14–1.85) and RR1.17 (95% CI 0.95–1.43), respectively). The results did not change when alternate practices to assign SPI history using administrative data were used. Conclusions Individuals with an SPI, especially those with a psychiatric admission, were more likely to have missing stage data compared to individuals without a history of a mental illness. Incomplete and low quality cancer staging data likely undermines the quality of cancer care following initial diagnosis. Understanding why patients with an SPI are missing this information is a critical first step to providing excellent care to this vulnerable population.
dc.rights info:eu-repo/semantics/openAccess
dc.title Cancer staging in individuals with a severe psychiatric illness: a cross-sectional study using population-based cancer registry data
dc.type Journal Article
dc.type info:eu-repo/semantics/article
dc.language.rfc3066 en
dc.rights.holder The Author(s)
dc.date.updated 2020-06-01T03:16:29Z

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