Participation in a Swedish cervical cancer screening program among women with psychiatric diagnoses: a population-based cohort study

Abstract

BackgroundIn Sweden, organized screening programs have significantly reduced the incidence of cervical cancer. For cancers overall, however, women with psychiatric diagnoses have lower survival rates than other women. This study explores whether women with psychiatric diagnoses participate in cervical cancer screening programs to a lesser extent than women on average, and whether there are disparities between psychiatric diagnostic groups based on grades of severity.MethodsBetween 2000 and 2010, 65,292 women within screening ages of 23–60 had at least two ICD-10 (International Statistical Classification of Diseases and Related Health Problems – Tenth Revision) codes F20*–F40* registered at visits in primary care or psychiatric care in Region Västra Götaland, Sweden. Participation in the cervical cancer screening program during 2010–2014 was compared with the general female population using logistic regression adjusted for age.ResultsRelative risk for participation (RR) for women diagnosed within psychiatric specialist care RR was 0.94 compared with the general population, adjusted for age. RR for diagnoses outside specialist care was 0.99. RR for psychoses (F20*) was 0.81.ConclusionsWomen with less-severe psychiatric diagnoses participate in the screening program to the same extent as women overall. Women who have received psychiatric specialist care participate to a lesser extent than women overall. The lowest participation rates were found among women diagnosed with psychoses.

The future of cancer screening after COVID‐19 may be at home

“…As examples, organized national screening programs for breast, colorectal, and cervical cancers across Europe and the United Kingdom have generally yielded reductions in cancer-related mortality as in the US; nevertheless, implementation still is incomplete, and participation rates vary. [47][48][49] Nonetheless, during a pandemic, these organized, nationally supported programs still can systematically offer cancer screening.…”

“…At a time when resources (staff, equipment, and supplies) are devoted to fighting the COVID‐19 pandemic and preparing for potential further rebounds, coordinated public health policy and multilevel approaches to implementation are warranted to support continued cancer screening in health care settings. As examples, organized national screening programs for breast, colorectal, and cervical cancers across Europe and the United Kingdom have generally yielded reductions in cancer‐related mortality as in the US; nevertheless, implementation still is incomplete, and participation rates vary 47‐49 . Nonetheless, during a pandemic, these organized, nationally supported programs still can systematically offer cancer screening.…”

Disability and Participation in Breast and Cervical Cancer Screening: A Systematic Review and Meta-Analysis

“…The most common type of disability included in this review was psychosocial disability, accounting for 47% of all studies ( n = 15), assessed as a psychiatric or mental health diagnosis, a history of psychiatric prescription, or self-reported mental status [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. One third (31.3%, n = 10) of the studies included used disability in general or combining different types of disability into a category of having a disability or no disability.…”

A randomised controlled trial of a case management approach to encourage participation in colorectal cancer screening for people with schizophrenia in psychiatric outpatient clinics: study protocol for the J-SUPPORT 1901 (ACCESS) study

“…However, a previous review has shown that there are lower cancer screening rates in people with mental illness 13. Among patients with mental illness, patients with schizophrenia have been suggested to have a particularly low cancer screening rate 14. Our previous study demonstrated that in Japan the colorectal cancer screening rate in people with schizophrenia was 24.1%, which is much lower than that of the general population at 40.7% 15.…”