Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studies
Background and purpose: Persons with severe mental illnesses (SMIs) have reduced participation in colorectal cancer (CRC) screening programs, higher odds of advanced stage at diagnosis, and are less likely to receive adequate treatment than the general population. It remains unclear to what extent t...
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Medical Journals Sweden
2025-03-01
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| Series: | Acta Oncologica |
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| Online Access: | https://medicaljournalssweden.se/actaoncologica/article/view/42260 |
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| author | Paula R. Pop Gitte S. Larsen Mette K. Thomsen Christoffer Johansen Robert Zachariae Bolette Skjødt Rafn |
| author_facet | Paula R. Pop Gitte S. Larsen Mette K. Thomsen Christoffer Johansen Robert Zachariae Bolette Skjødt Rafn |
| author_sort | Paula R. Pop |
| collection | DOAJ |
| description | Background and purpose: Persons with severe mental illnesses (SMIs) have reduced participation in colorectal cancer (CRC) screening programs, higher odds of advanced stage at diagnosis, and are less likely to receive adequate treatment than the general population. It remains unclear to what extent these factors impact CRC outcomes for persons with SMI. The aim of this scoping review was to describe and quantify CRC mortality for persons with SMI compared with the general population.
Patients/materials and methods: We followed the JBI Manual for Evidence Synthesis and PRISMA guidelines in a systematic search of four databases from inception until April 29th, 2024. We included studies that provided CRC mortality estimates for adults with preexisting clinical diagnosis of SMI. We synthesized the results descriptively and pooled the data to estimate the magnitude of the associations.
Results: Twenty-four original studies were identified with a total of 16.4 million persons. Most studies reported increased CRC mortality for persons with SMI compared with persons without SMI. The meta-analysis demonstrated a 25% increased CRC mortality for persons with SMI (e.g. pooled hazard ratio 1.25; 95% confidence interval 1.13 to 1.39; n = 13,178,161).
Interpretation: The evidence points consistently to an increased CRC mortality for persons with SMI compared with persons without SMI. Furthermore, this evidence supports the idea that persons with SMI are a heterogenous population, and as such, any future initiatives to improve CRC outcomes for persons with SMI would warrant a tailored approach to potentiate individual resources, to mitigate stigma and structural discrimination.
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| format | Article |
| id | doaj-art-92cacb31ea3347938ccff3ca47eb3e55 |
| institution | DOAJ |
| issn | 1651-226X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Oncologica |
| spelling | doaj-art-92cacb31ea3347938ccff3ca47eb3e552025-08-20T03:16:18ZengMedical Journals SwedenActa Oncologica1651-226X2025-03-016410.2340/1651-226X.2025.42260Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studiesPaula R. Pop0Gitte S. Larsen1https://orcid.org/0009-0008-1347-9715Mette K. Thomsen2https://orcid.org/0000-0001-7308-3431Christoffer Johansen3https://orcid.org/0000-0002-4384-206XRobert Zachariae4https://orcid.org/0000-0001-9076-3068Bolette Skjødt Rafn5https://orcid.org/0000-0001-8269-3100Danish Cancer Society National Research Center for Cancer Survivorship and Treatment Late Effects (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDanish Cancer Society National Research Center for Cancer Survivorship and Treatment Late Effects (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDanish Cancer Society National Research Center for Cancer Survivorship and Treatment Late Effects (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, DenmarkDanish Cancer Society National Research Center for Cancer Survivorship and Treatment Late Effects (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark3Danish Breast Cancer Group Center and Clinic for Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark; Unit for Psycho-oncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology and Behavioural Sciences, Aarhus University, DenmarkDanish Cancer Society National Research Center for Cancer Survivorship and Treatment Late Effects (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkBackground and purpose: Persons with severe mental illnesses (SMIs) have reduced participation in colorectal cancer (CRC) screening programs, higher odds of advanced stage at diagnosis, and are less likely to receive adequate treatment than the general population. It remains unclear to what extent these factors impact CRC outcomes for persons with SMI. The aim of this scoping review was to describe and quantify CRC mortality for persons with SMI compared with the general population. Patients/materials and methods: We followed the JBI Manual for Evidence Synthesis and PRISMA guidelines in a systematic search of four databases from inception until April 29th, 2024. We included studies that provided CRC mortality estimates for adults with preexisting clinical diagnosis of SMI. We synthesized the results descriptively and pooled the data to estimate the magnitude of the associations. Results: Twenty-four original studies were identified with a total of 16.4 million persons. Most studies reported increased CRC mortality for persons with SMI compared with persons without SMI. The meta-analysis demonstrated a 25% increased CRC mortality for persons with SMI (e.g. pooled hazard ratio 1.25; 95% confidence interval 1.13 to 1.39; n = 13,178,161). Interpretation: The evidence points consistently to an increased CRC mortality for persons with SMI compared with persons without SMI. Furthermore, this evidence supports the idea that persons with SMI are a heterogenous population, and as such, any future initiatives to improve CRC outcomes for persons with SMI would warrant a tailored approach to potentiate individual resources, to mitigate stigma and structural discrimination. https://medicaljournalssweden.se/actaoncologica/article/view/42260colon cancerpsychosisschizophreniaaffective disordershealth inequityprognosis |
| spellingShingle | Paula R. Pop Gitte S. Larsen Mette K. Thomsen Christoffer Johansen Robert Zachariae Bolette Skjødt Rafn Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studies Acta Oncologica colon cancer psychosis schizophrenia affective disorders health inequity prognosis |
| title | Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studies |
| title_full | Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studies |
| title_fullStr | Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studies |
| title_full_unstemmed | Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studies |
| title_short | Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studies |
| title_sort | colorectal cancer mortality in persons with severe mental illness a scoping review with meta analyses of observational studies |
| topic | colon cancer psychosis schizophrenia affective disorders health inequity prognosis |
| url | https://medicaljournalssweden.se/actaoncologica/article/view/42260 |
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