TY - JOUR
T1 - Risk of cancer in bipolar disorder and the potential role of lithium
T2 - International collaborative systematic review and meta-analyses
AU - Anmella, Gerard
AU - Fico, Giovanna
AU - Lotfaliany, Mojtaba
AU - Hidalgo-Mazzei, Diego
AU - Soto-Angona, Óscar
AU - Giménez-Palomo, Anna
AU - Amoretti, Silvia
AU - Murru, Andrea
AU - Radua, Joaquim
AU - Solanes, Aleix
AU - Pacchiarotti, Isabella
AU - Verdolini, Norma
AU - Cowdery, Stephanie
AU - Dodd, Seetal
AU - Williams, Lana J
AU - Mohebbi, Mohammadreza
AU - Carvalho, Andre F
AU - Kessing, Lars Vedel
AU - Vieta, Eduard
AU - Berk, Michael
N1 - Copyright © 2021 Elsevier Ltd. All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - We examined bipolar disorder (BD) as a risk factor for developing cancer and the role of lithium on cancer incidence. We conducted two systematic review and meta-analyses of population-based studies providing data on these associations. We screened articles indexed in MEDLINE, Scopus, Embase, and PsycINFO up to August 2020. The first random-effects meta-analysis, based on 4,910,661 individuals from nine studies estimated an increased risk of cancer of any kind [RR = 1.24 (1.05-1.46); p < 0.01], especially breast cancer [RR = 1.33 (1.15-1.55); p < 0.01] in BD. The second random-effects meta-analysis, based on 2,606,187 individuals from five studies did not show increased risk of cancer in people with BD using lithium, and even suggested a small protective effect both in overall [RR = 0.94 (0.72-1.22); p = 0.66] and urinary cancer [RR = 0.93 (0.75-1.14); p = 0.48] although these findings did not reach statistical significance. The current evidence highlights that cancer risk is increased in individuals with BD, particularly breast cancer in women. Lithium may have a potential protective effect on cancer, including urinary cancer. The role of lithium as a mainstay of treatment for BD is reinforced by this study.
AB - We examined bipolar disorder (BD) as a risk factor for developing cancer and the role of lithium on cancer incidence. We conducted two systematic review and meta-analyses of population-based studies providing data on these associations. We screened articles indexed in MEDLINE, Scopus, Embase, and PsycINFO up to August 2020. The first random-effects meta-analysis, based on 4,910,661 individuals from nine studies estimated an increased risk of cancer of any kind [RR = 1.24 (1.05-1.46); p < 0.01], especially breast cancer [RR = 1.33 (1.15-1.55); p < 0.01] in BD. The second random-effects meta-analysis, based on 2,606,187 individuals from five studies did not show increased risk of cancer in people with BD using lithium, and even suggested a small protective effect both in overall [RR = 0.94 (0.72-1.22); p = 0.66] and urinary cancer [RR = 0.93 (0.75-1.14); p = 0.48] although these findings did not reach statistical significance. The current evidence highlights that cancer risk is increased in individuals with BD, particularly breast cancer in women. Lithium may have a potential protective effect on cancer, including urinary cancer. The role of lithium as a mainstay of treatment for BD is reinforced by this study.
KW - Bipolar disorder
KW - Breast cancer
KW - Cancer
KW - Lithium
KW - Neuroscience
KW - Psychiatry
KW - Urinary cancer
UR - http://www.scopus.com/inward/record.url?scp=85104292731&partnerID=8YFLogxK
U2 - 10.1016/j.neubiorev.2021.03.034
DO - 10.1016/j.neubiorev.2021.03.034
M3 - Review
C2 - 33831461
VL - 126
SP - 529
EP - 541
JO - Neuroscience & Biobehavioral Reviews
JF - Neuroscience & Biobehavioral Reviews
SN - 0149-7634
ER -