Cancer screening participation in schizophrenic outpatients and the influence of their functional disability on the screening rate: <scp>A</scp> cross‐sectional study in <scp>J</scp>apan

Fujiwara, Masaki; Inagaki, Masumi; Nakaya, Naoki; Fujimori, Maiko; Higuchi, Yuji; Hayashibara, Chinatsu; So, Ryuhei; Kakeda, Kyoko; Kodama, Masafumi; Uchitomi, Yosuke; Yamada, Norihito

doi:10.1111/pcn.12554

Cited by 32 publications

(36 citation statements)

References 33 publications

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“…Our previous study found associations between social or physical factors and cancer screening non-participation in Japan (Fujiwara et al 2017). We found that symptom severity and functional disability related to schizophrenia were the most consistent risk factors for a lack of participation in screenings for all types of cancer.…”

Section: Introductionmentioning

confidence: 68%

“…To the best of our knowledge, this is the first study to report local government record-based cancer screening rates among people with severe mental illness in Japan. Our previous study showed that the self-reported rates of cancer screenings among schizophrenic outpatients were 19.4%-30.8%, and that these rates were approximately onehalf those among the general population (Fujiwara et al 2017). These rates included any type of cancer screening, regardless of provider (municipal cancer screening, collective opportunistic cancer screening, and individual opportunistic screening).…”

Section: Discussionmentioning

confidence: 99%

“…SHEAPS is a cross-sectional study with two related aims: to investigate cancer screening behaviors and to study smoking behaviors in patients with schizophrenia. We have previously described the study methods in detail (Fujiwara et al 2017) and include methodogical details here. SHEAPS participants were recruited in an outpatient clinic at the Okayama Psychiatric Medical Center in Japan.…”

Section: Study Design and Settingmentioning

confidence: 99%

“…As described previously (Fujiwara et al 2017), the SHEAPS inclusion criteria were as follows: on April 1, 2016, (i) patients aged 20-69 years; (ii) those who had visited the Okayama Psychiatric Medical Center for 1 or more years, and had visited the hospital twice or more in the last 6 months as their primary psychiatric outpatient service; and (iii) those who had been diagnosed by their primary psychiatrist with schizophrenia or schizoaffective disorder, but not other schizophrenia spectrum disorders, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychiatric Association 2013). The exclusion criteria were as follows: (i) patients comorbid for intellectual disabilities and unable to answer the questionnaire; (ii) those with psychiatric symptoms too severe to make study participation appropriate (as judged by their primary psychiatrist); (iii) those incapable of study participation because their physical status was too severe (as judged by their primary psychiatrist); and (iv) those unable to read or write in Japanese.…”

Section: Participantsmentioning

confidence: 99%

“…There are few studies on this issue in Asia, even when including studies of individuals with mental illness not restricted to schizophrenia (Lin et al 2010;Mo et al 2014;Yen et al 2015), and there are no studies on gastric and lung cancer screening among people with schizophrenia. We recently reported that outpatients with schizophrenia are less likely to participate in nationally recommended cancer screening (colorectal, gastric, lung, breast, and cervical cancer screening) than the general population (Fujiwara et al 2017). These cancer screening rates in people with schizophrenia were approximately one-half the rates of nearly 40% of the general population.…”

Section: Introductionmentioning

confidence: 99%

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Low Cancer Screening Rates among Japanese People with Schizophrenia: A Cross-Sectional Study

Inagaki

Fujiwara

Nakaya

et al. 2018

Tohoku J. Exp. Med.

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Health care disparities among people with schizophrenia is a global concern. Our previous study revealed cancer screening rates in Japanese people with schizophrenia lower than rates of approximately 40% of the general population. However, that study was based on self-reports, which can be inaccurate, and rates did not differentiate the types of cancer screening provider (i.e., municipal screening, collective opportunistic screening, and individual opportunistic screening). This study aimed to investigate recordsbased cancer screening rates, focusing on participation rates of people with schizophrenia who are subject to municipal cancer screening programs. We conducted a cross-sectional study at a psychiatric hospital outpatient clinic from September to November 2016. We randomly extracted 420 potential participants from among 680 eligible patients and asked them to participate. We then selected subgroups of participants living in Okayama city who were enrolled in the National Health Insurance or Public Assistance systems and were subject to colorectal, gastric, lung, breast, or cervical cancer screening provided by Okayama city (n = 97, 96, 97, 42, and 64, respectively). Participation in cancer screenings was assessed based on local government records. Municipal cancer screening rates were as follows: 13.4% (95% confidence interval: 6.6%-20.2%) for colorectal, 7.3% (2.1%-12.5%) for gastric, 16.5% (9.1%-23.9%) for lung, 21.4% (9.0%-33.8%) for breast, and 14.1% (5.6%-22.6%) for cervical cancers. The findings demonstrated extremely low cancer screening rates among people with schizophrenia subject to municipal cancer screenings in Japan. A strategy to promote municipal cancer screening for people with schizophrenia is needed.

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Section: Introductionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Study Design and Settingmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Low Cancer Screening Rates among Japanese People with Schizophrenia: A Cross-Sectional Study

Inagaki

Fujiwara

Nakaya

et al. 2018

Tohoku J. Exp. Med.

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Case report: Schizophrenia and hypertrophic osteoarthropathy, a rare syndrome hiding a life‐threatening condition

Baklouti

Karoui

Kammoun

et al. 2022

Clinical Case Reports

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Cancer and severe mental illness: Bi‐directional problems and potential solutions

Grassi

Riba

2020

Psycho-Oncology

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Objective: Given the reported increased rates of physical morbidity and higher mortality rates among people with severe mental illness (SMI) (schizophrenia and severe mood disorders), with a life expectancy shorter of 15-20 years with respect to the general population, the aim of this paper was to call attention to the problem of cancer in SMI. Methods: We conducted a narrative review of the most significant papers published in the areas of cancer screening, incidence, mortality and palliative care in SMI. Results: Data from the literature confirm disparities in screening (eg, mammography; pap-smear test; colorectal cancer screening) and prevention (eg, clinical breast examination; smoking cessation). The incidence of cancer was found to be variable with a portion of the studies reporting a higher prevalence while others a similar or a lower prevalence of cancer compared to the general population. A lower percentage of patients with SMI received proper cancer treatment resulting in survival after cancer diagnosis significantly worse than people without SMI. Likewise, end-of-life care has been shown to be lacking with poorer levels of physical, psychological and spiritual care. Conclusions: The problems of stigma and discrimination, poorer dignity, poorer health behavior, lack of integration in health-care services for people with SMI needs to be addressed and solved in cancer care. Psycho-oncology has a very specific and mandatory role in integrating the recommendation of the World Health Organization to improve the links between oncology and mental health settings for more specific psycho-oncology programs addressed for this vulnerable segment of the population.

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Cancer screening participation in schizophrenic outpatients and the influence of their functional disability on the screening rate: A cross‐sectional study in Japan

Abstract: The findings demonstrated low rates of cancer screenings in schizophrenic patients in Japan. Our study suggests the need to encourage attendance at cancer screenings, especially in schizophrenic patients with severe symptoms/functional disability.

Cited by 32 publications

References 33 publications

Low Cancer Screening Rates among Japanese People with Schizophrenia: A Cross-Sectional Study

Low Cancer Screening Rates among Japanese People with Schizophrenia: A Cross-Sectional Study

Case report: Schizophrenia and hypertrophic osteoarthropathy, a rare syndrome hiding a life‐threatening condition

Cancer and severe mental illness: Bi‐directional problems and potential solutions

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