Disparities in cancer screening in people with mental illness across the world versus the general population: prevalence and comparative meta-analysis including 4 717 839 people

Solmi, Marco; Firth, Joseph; Miola, Alessandro; Fornaro, Michele; Frison, Elisabetta; Fusar‐Poli, Paolo; Dragioti, Elena; Smıth, Lee; Carvalho, André F.; Stubbs, Brendon; Koyanagi, Ai; Kisely, Steve; Correll, Christoph U.

doi:10.1016/s2215-0366(19)30414-6

Cited by 149 publications

(146 citation statements)

References 92 publications

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“…A very large and recent metanalysis involving almost 5 million people (501 559 patients with mental illness, and 4 216 280 controls) from 47 publications and involving many possible mental illnesses (ie, schizophrenia or schizoaffective or psychosis, depression or bipolar disorder or mania, eating disorder or anorexia nervosa or bulimia nervosa or binge eating disorder, obsessive‐compulsive disorders, post‐trauamtic stress disorder, anxiety disorder or panic disorder) provided a global overview of the problem. Data included studies relative to screening for cancer with results showing that screening was significantly less frequent in people with any mental disease compared with the general population for breast cancer, cervical cancer, and prostate cancer, but not for colorectal cancer 26 …”

Section: Prevention Issues and Screening For Cancer In People With Smimentioning

confidence: 99%

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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Section: Prevention Issues and Screening For Cancer In People With Smimentioning

confidence: 99%

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

Grassi

Riba

2020

Psycho-Oncology

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“…Underreporting is more likely for those whose histology or cytology verification is missing, which most commonly occurs when cancer is diagnosed at an advanced stage and the patient receives only palliative care (Barlow et al, 2009). People with schizophrenia have low rates of participation in general health and cancer screening programmes (Fujiwara et al, 2017;Hwong et al, 2020;Solmi et al, 2020), and delayed and late-stage cancer diagnoses are common in this patient population (Farasatpour et al, 2013). To compensate the underreporting in the Swedish Cancer Register and minimise possible differential completeness in reporting, we used additional data on incident cancers from other nationwide registers, including the National Patient Register or the Swedish Cause of Death Register.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The overall and sex- and age-group specific incidence rates of cancer in people with schizophrenia: a population-based cohort study

Pettersson

Gissler

Hällgren

et al. 2020

Epidemiol Psychiatr Sci

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Aims Decades of research show that people with schizophrenia have an increased risk of death from cancer; however, the relationship between schizophrenia and cancer incidence remains less clear. This population-based study investigates the incidence of seven common types of cancer among people with a hospital diagnosis of schizophrenia and accounting for the effects of age, sex and calendar time. Methods This population-based study used 1990–2013 data from three nationwide Swedish registries to calculate the incidence (in total, by age group and by sex) of any cancer and of lung, oesophageal, pancreatic, stomach, colon, (in men) prostate and (in women) breast cancer in 111 306 people with a hospital diagnosis of schizophrenia. The incidence in people with diagnosed schizophrenia was compared with the incidence in the general population. Risk estimates accounted for the effects of calendar time. Results In 1 424 829 person-years of follow-up, schizophrenia did not confer an overall higher cancer risk (IRR 1.02, 95% CI 0.91–1.13) but was associated with a higher risk for female breast (IRR 1.19, 95% CI 1.12–1.26), lung (IRR 1.42, 95% CI 1.28–1.58), oesophageal (IRR 1.25, 95% CI 1.07–1.46) and pancreatic (IRR 1.10, 95% CI 1.01–1.21) and a lower risk of prostate (IRR 0.66, 95% CI 0.55–0.79) cancer. Some age- and sex-specific differences in risk were observed. Conclusions People with schizophrenia do not have a higher overall incidence of cancer than people in the general population. However, there are significant differences in the risk of specific cancer types overall and by sex calling for efforts to develop disease-specific prevention programmes. In people with schizophrenia, higher risk generally occurs in those <75 years.

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“…Lindamer and colleagues [77] found that women with schizophrenia took part in pelvic examinations, Pap tests and mammography screening significantly less frequently than controls [77]. This relatively low participation in cancer screening is also true for breast and colon screening [78,79].…”

Section: Treatment and Health Care Needs In Women With Schizophrenia mentioning

confidence: 99%

Women with Schizophrenia over the Life Span: Health Promotion, Treatment and Outcomes

González-Rodríguez

Guàrdia²,

Pedrero

et al. 2020

IJERPH

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Women with schizophrenia show sex-specific health needs that differ according to stage of life. The aim of this narrative review is to resolve important questions concerning the treatment of women with schizophrenia at different periods of their life—paying special attention to reproductive and post-reproductive stages. Review results suggest that menstrual cycle-dependent treatments may be a useful option for many women and that recommendations re contraceptive options need always to be part of care provision. The pregnancy and the postpartum periods—while constituting vulnerable time periods for the mother—require special attention to antipsychotic effects on the fetus and neonate. Menopause and aging are further vulnerable times, with extra challenges posed by associated health risks. Pregnancy complications, neurodevelopmental difficulties of offspring, cancer risk and cognitive defects are indirect results of the interplay of hormones and antipsychotic treatment of women over the course of the lifespan. The literature recommends that health promotion strategies need to be directed at lifestyle modifications, prevention of medical comorbidities and increased psychosocial support. Careful monitoring of pharmacological treatment has been shown to be critical during periods of hormonal transition. Not only does treatment of women with schizophrenia often need to be different than that of their male peers, but it also needs to vary over the course of life.

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Disparities in cancer screening in people with mental illness across the world versus the general population: prevalence and comparative meta-analysis including 4 717 839 people

Cited by 149 publications

References 92 publications

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

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

The overall and sex- and age-group specific incidence rates of cancer in people with schizophrenia: a population-based cohort study

Women with Schizophrenia over the Life Span: Health Promotion, Treatment and Outcomes

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