Evidence map›Paper›PMID 41784654›Full record

ArticleSocial psychiatry and psychiatric epidemiology2026

Mortality following cancer diagnosis among people with non-affective psychoses: mediation by stage at diagnosis and time to treatment initiation.

Jared C Wootten, Lucie Richard, Igor Karp, Phillip S Blanchette, Marco Solmi, Kelly K Anderson

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Article in Social psychiatry and psychiatric epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Jared C WoottenDepartment of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Public Health and Family Medicine, Western University, Room 3146A 1465 Richmond Street, N6G 2M1, London, ON, Canada. jwootte@uwo.ca.
Lucie RichardICES Western, London, ON, Canada.
Igor KarpDepartment of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Public Health and Family Medicine, Western University, Room 3146A 1465 Richmond Street, N6G 2M1, London, ON, Canada.
Phillip S BlanchetteDepartment of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Public Health and Family Medicine, Western University, Room 3146A 1465 Richmond Street, N6G 2M1, London, ON, Canada.
Marco SolmiDepartment of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
Kelly K AndersonDepartment of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Public Health and Family Medicine, Western University, Room 3146A 1465 Richmond Street, N6G 2M1, London, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople with psychotic disorders have greater mortality rates following cancer diagnosis, compared to people without psychotic disorders. Prior examinations of the effect of psychotic disorders on survival following cancer diagnosis mediated by stage at diagnosis and treatment disparities did not accommodate for multiple mediators and post-exposure confounding. The present study sought to estimate analogues of the natural indirect effects of having NAPD on mortality following cancer diagnosis, mediated through stage at diagnosis and time to treatment initiation.

methodsWe identified cases of cancer diagnosed between 1995 and 2019 among people with non-affective psychotic disorders (NAPD) and a comparison group without NAPD, constructed using Ontario health administrative data. Death from any cause was identified using register data. Inverse probability of treatment weighted Cox models were used to estimate the effect of NAPD on mortality following cancer diagnosis mediated by stage at diagnosis and time to treatment initiation, adjusting for relevant confounders.

resultsThe analytic sample included 3,643 people with NAPD and 15,174 people without NAPD who developed cancer. People with NAPD had a 66% greater adjusted hazard of all-cause mortality than people without NAPD (95%CI = 1.55,1.78). The HR estimate for the indirect effect mediated through stage at diagnosis was 1.09 (95%CI = 1.05,1.13) and HR estimate for the indirect effect mediated through time to treatment initiation was 1.00 (95%CI = 0.96,1.04).

conclusionsOur findings suggest that a relatively small proportion of the effect of NAPD on mortality is mediated by stage at diagnosis, while time to treatment initiation does not mediate that effect. This excess risk is potentially mediated by other patient, provider, and system-related factors in cancer care.

Indexed as

NeoplasmsPsychotic DisordersTime-to-TreatmentAdultAgedFemaleHumansMaleMiddle AgedOntarioProportional Hazards ModelsRegistriesCancerMediationMortalityPsychosisSchizophreniaStage at diagnosisTreatment

Identifiers

PMID41784654
PMCPMC13424192

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