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Peer-reviewedCC BYTranslational psychiatry

Cancer risk among individuals with mental illness - a systematic review and meta-analysis of nordic register-based prospective studies.

  • Xue Xiao1,2
  • Fatemeh Sadeghi3
  • Gillian Murphy4
  • Zhe Zhang5,6
  • Ole A Andreassen7,8
  • Unnur Valdimarsdóttir4,9,10
  • Fang Fang4
  • Mary M Barker4
10 affiliations
  1. 1Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
  2. 2Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education & Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Nanning, Guangxi, China.
  3. 3Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
  4. 4Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
  5. 5Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China. [email protected].
  6. 6Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education & Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Nanning, Guangxi, China. [email protected].
  7. 7NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway.
  8. 8Oslo University Hospital, Oslo, Norway.
  9. 9Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
  10. 10Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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Abstract

Although cancer patients have a high burden of mental illness, it is less clear whether patients with mental illness experience a higher-than-expected cancer risk. This systematic review investigated the associations between a wide range of types of mental illness and subsequent cancer risk. Five electronic databases were searched for articles published from database initiation to October 24, 2024. Studies using nationwide Nordic register data to conduct a prospective analysis of the association between mental illness diagnosis and cancer incidence were included. When data from three or more countries were available for a given type of mental illness, random effects meta-analyses were performed; otherwise, narrative syntheses were conducted. A total of 7,767 non-duplicate articles were screened, of which 20 were included. Meta-analyses showed no association between schizophrenia diagnosis and overall cancer risk; however, a high level of heterogeneity was detected between studies. Individuals with schizophrenia appeared to have a higher risk of breast cancer (pooled standardized incidence ratio [SIR]: 1.28, 95% confidence interval [CI]: 1.08-1.52), and lower risks of rectal cancer (pooled SIR: 0.75, 95% CI: 0.59-0.95) and prostate cancer (pooled SIR: 0.53, 95% CI: 0.48-0.59), compared to individuals in the general population. A higher risk of overall cancer was observed for mood, anxiety, and stress-related disorders, as well as autism and intellectual disability, in multiple studies; however, the results differed by cancer types and sex. In summary, these findings suggest an altered risk of cancer among individuals with mental illness living in Nordic countries. Further research is needed to enable the development of targeted cancer prevention strategies to reduce mental health disparities in cancer protection.

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Cite

BibTeXRIS
BibTeX
@article{xiao2026cancer,
  title = {{Cancer risk among individuals with mental illness - a systematic review and meta-analysis of nordic register-based prospective studies.}},
  author = {Xue Xiao and Fatemeh Sadeghi and Gillian Murphy and Zhe Zhang and Ole A Andreassen and Unnur Valdimarsdóttir and Fang Fang and Mary M Barker},
  journal = {Translational psychiatry},
  year = {2026},
  month = aug,
  doi = {10.1038/s41398-026-04351-5},
  url = {https://europepmc.org/article/MED/42957628},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Cancer risk among individuals with mental illness - a systematic review and meta-analysis of nordic register-based prospective studies.
AU  - Xue Xiao
AU  - Fatemeh Sadeghi
AU  - Gillian Murphy
AU  - Zhe Zhang
AU  - Ole A Andreassen
AU  - Unnur Valdimarsdóttir
AU  - Fang Fang
AU  - Mary M Barker
PY  - 2026
DA  - 2026/08/01
JO  - Translational psychiatry
DO  - 10.1038/s41398-026-04351-5
UR  - https://europepmc.org/article/MED/42957628
AB  - Although cancer patients have a high burden of mental illness, it is less clear whether patients with mental illness experience a higher-than-expected cancer risk. This systematic review investigated the associations between a wide range of types of mental illness and subsequent cancer risk. Five electronic databases were searched for articles published from database initiation to October 24, 2024. Studies using nationwide Nordic register data to conduct a prospective analysis of the association between mental illness diagnosis and cancer incidence were included. When data from three or more countries were available for a given type of mental illness, random effects meta-analyses were performed; otherwise, narrative syntheses were conducted. A total of 7,767 non-duplicate articles were screened, of which 20 were included. Meta-analyses showed no association between schizophrenia diagnosis and overall cancer risk; however, a high level of heterogeneity was detected between studies. Individuals with schizophrenia appeared to have a higher risk of breast cancer (pooled standardized incidence ratio [SIR]: 1.28, 95% confidence interval [CI]: 1.08-1.52), and lower risks of rectal cancer (pooled SIR: 0.75, 95% CI: 0.59-0.95) and prostate cancer (pooled SIR: 0.53, 95% CI: 0.48-0.59), compared to individuals in the general population. A higher risk of overall cancer was observed for mood, anxiety, and stress-related disorders, as well as autism and intellectual disability, in multiple studies; however, the results differed by cancer types and sex. In summary, these findings suggest an altered risk of cancer among individuals with mental illness living in Nordic countries. Further research is needed to enable the development of targeted cancer prevention strategies to reduce mental health disparities in cancer protection.
SN  - 2158-3188
ER  -