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PAPERS:
MICHAEL J. GOLDACRE, LIANNE M. KURINA, CLARE J. WOTTON, DAVID YEATES, and VALERIE SEAGROAT
Schizophrenia and cancer: an epidemiological study
The British Journal of Psychiatry 2005; 187: 334-338 [Abstract] [Full text] [PDF]
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[Read eLetter] Schizophrenia and skin cancer
David M. Lawrence   (21 August 2008)

Schizophrenia and skin cancer 21 August 2008
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David M. Lawrence,
Statistician
Centre for Developmental Health, Curtin University of Technology

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Re: Schizophrenia and skin cancer

D.Lawrence{at}curtin.edu.au David M. Lawrence

It has only just come to my attention that in their article Goldacre et al suggest that as my colleagues and I have access to a large population linked database we could illuminate their findings. They reported no difference in cancer incidence rates between people with schizophrenia and the general population except for skin cancer where they observed an adjusted rate ratio for malignant melanoma of 0.2 (95% CI: 0.02 - 0.74), and wondered if we could calculate similar figures. In fact, we published these figures in 2001 [1] and reported no difference in incidence of malignant melanoma between people with schizophrenia and the general population (RR of 0.76 (0.42-1.38) for males and 0.93 (0.50-1.71) for females). Given that Goldacre et al's conclusion was based on 2 observed melanomas when 9.7 were expected, and they performed tests for 33 cancer sites and found only one significant difference while not making any adjustment for multiple testing, our view remains that there is no difference in cancer incidence between people with schizophrenia and the general population, although case fatality seems worse.

[1] Lawrence D, Holman CDJ, Jablensky AV (2001). Duty to Care. Preventable physical illness in people with mental illness. Perth: University of Western Australia.