A team led by Dr. Robert Kerrison from the University of Surrey found that people with a severe mental illness such as schizophrenia or bipolar disorder had significantly lower cancer screening attendance than those without such conditions. It also found that participation was lowest for those living in the most deprived quintile of areas, as well as those who are Black or Asian.
"This study highlights the complexity of inequality in participation in cancer screening, within and between populations with and without severe mental illnesses," Kerrison and colleagues wrote.
Previous research suggests that people with severe mental illnesses are 2.5 times more likely to die prematurely from cancer in England. The Kerrison team hypothesized that lower participation in cancer screening may contribute to this trend.
The researchers sought to assess whether inequalities in cancer screening participation persist after controlling for additional factors, to test possible associations between specific severe mental illnesses and participation in breast, bowel, and cervical screening, and to identify subgroups of people with such illnesses who are least likely to participate in screening.
They used data from the Clinical Practice Research Datalink that included 1.71 million people eligible for bowel cancer screening, 1.34 million for breast cancer, and 2.5 million for cervical cancer.
Kerrison and co-authors found significantly lower overall participation among adults with a severe mental illness for the three cancers. All results were statistically significant.
|Cancer screening participation among those with, without severe mental illness
|Cancer screening type
||Without severe mental illness
||With severe mental illness
The researchers reported that participation was lowest for people with schizophrenia, followed by those with other psychoses and those with bipolar disorder. They also found that some of the lowest participation numbers came from people living in the most deprived areas, at 36.2% for bowel cancer screening, 40.2% for breast cancer screening, and 61.5% for cervical cancer screening.
Black individuals had low screening uptake, at 34.7% for bowel cancer, 38.7% for breast cancer, and 64.8% for cervical cancer screening, while Asians had some of the lowest participation numbers, at 35.9% for bowel, 40.9% for breast, and 57.9% for cervical cancer.
The authors wrote that the study results support the need for the National Health Service Long Term Plan, which aims to increase access to annual physical health checks for adults with a severe mental illness.
"[Our study highlights] the need for specific action to support people with schizophrenia, as well as the need for extra support for people with severe mental illnesses living in socioeconomically deprived and ethnically diverse areas," they concluded.
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