People with mental illness less likely to get cancer screening

Lead author Dr. Marco Solmi, a psychiatrist and researcher at the University of Padua in Italy and colleagues said: “Early cancer screening has been shown to reduce mortality, and delayed cancer diagnosis among people with mental illness could be one reason they are also more likely to die of cancer than the general population.”

They found cancer screening rates were poor even among people with more common mental health issues like mood disorders. Disparities were also largest in places where health care has improved the most for the general population. The analysis included 501,559 adults with mental illness and 4.2 million in the general population of the Americas, Asia, Australia and Europe.

The following is an article concerning this issue written by ‘Vishwadha Chander’ under the heading: “People with mental illness less likely to get cancer screening.” The article has appeared on the frontpage of the Reuters’ news agency’s website.

Researchers say people with mental illness get screened for cancer at much lower rates than the general population, which may contribute to higher rates of cancer deaths among the mentally ill.

According to Reuters, in a review of 47 previous studies covering 4.7 million people in 10 countries, the study team found that adults with mental health issues were 24 percent less likely overall to get screened for cancer compared with the general population.

The disparities were greatest among women with schizophrenia, who were roughly half as likely as women in the general population to be screened for breast cancer.

Lead author Dr. Marco Solmi, a psychiatrist and researcher at the University of Padua in Italy, told Reuters Health “The most significant finding is women suffer from these disparities, in particular, those with schizophrenia.”

Solmi and colleagues write in The Lancet Psychiatry: “Early cancer screening has been shown to reduce mortality, and delayed cancer diagnosis among people with mental illness could be one reason they are also more likely to die of cancer than the general population.”

They found cancer screening rates were poor even among people with more common mental health issues like mood disorders. Disparities were also largest in places where health care has improved the most for the general population.
The analysis included 501,559 adults with mental illness and 4.2 million in the general population of the Americas, Asia, Australia and Europe.

Solmi’s team looked at screening rates among people with depression, schizophrenia and mixed mental disorders, and at screening for all cancers, as well as breast, cervical and prostate cancers specifically.

They found that women with schizophrenia were 48 percent less likely than those in the general population to be screened for breast cancer, and 25 percent less likely to be screened for cervical cancer.

People with schizophrenia were also, in general, about 38 percent less likely than the rest of the population to receive screenings for any cancer.

Men with any mental illness were 22 percent less likely overall to be screened for prostate cancer. Women with any mental illness were 35 percent less likely to be screened for breast cancer and 11 percent less likely to be screened for cervical cancer.

The study found colon cancer screening was the only category that did not show an overall disparity.

The authors say better coordination between mental health specialists and primary care professionals could help to close screening gaps.

Solmi said in an email “A possible approach to increase cancer screening rates among people with mental health issues may be to have case managers, nurses, social workers or other professionals who are given clear indications by doctors on what screenings are necessary and with what frequency,” adding, “Case managers can keep track of patients with mental illness and encourage them to comply with screening calendars.”

Dr. Steven Dubovsky, Chair of Psychiatry at the State University of New York at Buffalo, who wasn’t involved in the study said “Many patients with severe mental illnesses live in areas with little access to cancer screening centers.”

He told Reuters Health in a phone interview “People may not have cars, public transportation may not be good enough to reach a cancer screening center and the average doctor’s office may not have the facilities for basic cancer screenings such as a mammogram.”

He added “Patients with severe mental illnesses have other things on their minds, like how to function every day, beyond when to schedule a mammogram or prostate exam.”

Dubovsky agreed on the need for closer collaboration between medical and psychiatric health providers but pointed out they don’t get paid for collaborating care.

He said “Lawmakers must see the benefits of collaborative care and put some money into it.”

Dr. Paul Thielking, Director of Psycho-Oncology at the Huntsman Cancer Hospital in Salt Lake City, Utah, who wasn’t involved in the study ‘Better outreach by hospitals could be a solution’, said: “Most people get cancer screening done in primary care offices, and people with serious mental health issues may not access primary care doctors often and their mental health provider may not do cancer screening.”

ME