Association of Comorbid Schizophrenia with Cancer Stage at Admission, Treatments, Length of Stay, and 30-Day In-Hospital Mortality in Patients with Pancreatic Cancer: A Retrospective Matched-Pair Cohort Study in Japan
Menée au Japon à partir de données portant sur des patients atteints d'un cancer du pancréas, cette étude de cohorte rétrospective analyse l'association entre la présence d'une schizophrénie, le stade du cancer lors de l'admission hospitalière, la durée du séjour hospitalier et la mortalité à 30 jours
Background: Previous studies have suggested an association between comorbid schizophrenia and various outcomes in patients with cancer, including cancer stage at admission, treatment, and in-hospital mortality. However, studies focusing specifically on patients with pancreatic cancer are limited.
Aims: This study aimed to elucidate the association between comorbid schizophrenia and cancer stage at admission, treatment, length of stay, and 30-day in-hospital mortality in patients with pancreatic cancer, while considering patient background factors, medical facilities, and year of treatment.
Method: We conducted a retrospective matched-pair cohort study using data from the Japanese Diagnosis Procedure Combination database. Patients with pancreatic cancer and comorbid schizophrenia were matched to those without psychiatric disorders at a maximum ratio of 1:4 according to sex, age group, year of admission, and admission facility. Each matched pair was treated as a cluster, and multivariable regression analyses using generalised estimating equations were performed to evaluate the association between psychiatric comorbidities and cancer-related outcomes.
Results: After adjusting for patient background factors, medical facilities, and the year of treatment, patients with comorbid schizophrenia were significantly more likely to be admitted with stage IV cancer, less likely to undergo chemotherapy, and more likely to have longer hospital stays and higher 30-day in-hospital mortality than those without psychiatric disorders. Although not statistically significant, patients with schizophrenia were less likely to undergo cancer-directed surgery.
Conclusions: Patients with pancreatic cancer and comorbid schizophrenia were significantly more likely to present with advanced cancer at admission, were less likely to receive chemotherapy, had longer hospital stays, and experienced higher 30-day in-hospital mortality than those without psychiatric disorders. Although not statistically significant, patients with schizophrenia were less likely to undergo cancer-directed surgery.
European Journal of Cancer , résumé 2025