{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T10:03:34Z","timestamp":1793873014392,"version":"4.6.1"},"reference-count":59,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"unspecified","delay-in-days":320,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Early Career Fellowship: GNT11111136"],"award-info":[{"award-number":["Early Career Fellowship: GNT11111136"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001111","name":"Cancer Australia","doi-asserted-by":"publisher","award":["APP1157870"],"award-info":[{"award-number":["APP1157870"]}],"id":[{"id":"10.13039\/501100001111","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S2045796022000634_sec_a1\"><jats:title>Aims<\/jats:title><jats:p>People with severe mental illness (SMI) have a greater risk of dying from colorectal cancer (CRC), even though the incidence is lower or similar to that of the general population This pattern is unlikely to be solely explained by lifestyle factors, while the role of differences in cancer healthcare access or treatment is uncertain<\/jats:p><\/jats:sec><jats:sec id=\"S2045796022000634_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>We undertook a systematic review and meta-analysis on access to guideline-appropriate care following CRC diagnosis in people with SMI including the receipt of surgery, chemo- or radiotherapy. We searched for full-text articles indexed by PubMed, EMBASE, PsychInfo and CINAHL that compared CRC treatment in those with and without pre-existing SMI (schizophrenia, schizoaffective, bipolar and major affective disorders). Designs included cohort or population-based case\u2013control designs.<\/jats:p><\/jats:sec><jats:sec id=\"S2045796022000634_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>There were ten studies (sample size = 3501\u2013591 561). People with SMI had a reduced likelihood of surgery (RR = 0.90, 95% CI 0.92\u20130.97;<jats:italic>p<\/jats:italic>= 0.005;<jats:italic>k<\/jats:italic>= 4). Meta-analyses were not possible for the other outcomes but in results from individual studies, people with SMI were less likely to receive radiotherapy, chemotherapy or sphincter-sparing procedures. The disparity in care was greatest for those who had been psychiatric inpatients.<\/jats:p><\/jats:sec><jats:sec id=\"S2045796022000634_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>People with SMI, including both psychotic and affective disorders, receive less CRC care than the general population. This might contribute to higher case-fatality rates for an illness where the incidence is no higher than that of the general population. The reasons for this require further investigation, as does the extent to which differences in treatment access or quality contribute to excess CRC mortality in people with SMI.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s2045796022000634","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T06:14:53Z","timestamp":1668665693000},"source":"Crossref","is-referenced-by-count":27,"title":["Colorectal cancer treatment in people with severe mental illness: a systematic review and meta-analysis"],"prefix":"10.1017","volume":"31","author":[{"given":"Melinda M.","family":"Protani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meshary Khaled N.","family":"Alotiby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Seth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lawrence","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J.","family":"Jordan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayley","family":"Logan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley J.","family":"Kendall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Siskind","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3762-1711","authenticated-orcid":false,"given":"Grant","family":"Sara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4021-2924","authenticated-orcid":false,"given":"Steve","family":"Kisely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"key":"S2045796022000634_ref26","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1352\/0895-8017(2001)106<0416:DORAR>2.0.CO;2","article-title":"Diagnostic overshadowing reviewed and reconsidered","volume":"106","author":"Jopp","year":"2001","journal-title":"American Journal on Mental Retardation"},{"key":"S2045796022000634_ref28","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1007\/s11606-008-0720-z","article-title":"Quality of care for cardiovascular disease-related conditions in patients with and without mental disorders","volume":"23","author":"Kilbourne","year":"2008","journal-title":"Journal of General Internal Medicine"},{"key":"S2045796022000634_ref57","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1245\/s10434-015-4791-x","article-title":"Psychiatric illness is a disparity in the surgical management of rectal cancer","volume":"22","author":"Wieghard","year":"2015","journal-title":"Annals of Surgical Oncology"},{"key":"S2045796022000634_ref48","doi-asserted-by":"crossref","first-page":"e044737","DOI":"10.1136\/bmjopen-2020-044737","article-title":"Colorectal cancer outcomes in people with severe mental illness cohort (COSMIC): a protocol for an Australian retrospective cohort using linked administrative data","volume":"11","author":"Protani","year":"2021","journal-title":"BMJ Open"},{"key":"S2045796022000634_ref18","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jss.2017.06.028","article-title":"Psychiatric disease in surgically treated colorectal cancer patients","volume":"223","author":"Ho","year":"2018","journal-title":"Journal of Surgical Research"},{"key":"S2045796022000634_ref39","doi-asserted-by":"crossref","first-page":"99","DOI":"10.6004\/jnccn.2009.0009","article-title":"Impact of chemotherapy dose intensity on cancer patient outcomes","volume":"7","author":"Lyman","year":"2009","journal-title":"Journal of the National Comprehensive Cancer Network"},{"key":"S2045796022000634_ref38","doi-asserted-by":"crossref","first-page":"f2539","DOI":"10.1136\/bmj.f2539","article-title":"The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers","volume":"346","author":"Lawrence","year":"2013","journal-title":"British Medical Journal"},{"key":"S2045796022000634_ref37","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1034\/j.1600-0447.2000.101005382.x","article-title":"Excess cancer mortality in Western Australian psychiatric patients due to higher case fatality rates","volume":"101","author":"Lawrence","year":"2000","journal-title":"Acta Psychiatrica Scandinavica"},{"key":"S2045796022000634_ref59","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1001\/jama.280.19.1690","article-title":"What's the relative risk? 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