Cancer screenings less likely in people with mental illness

  • Lancet Psychiatry

  • Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Patients with mental illness are significantly less likely to receive cancer screenings than those without mental illness, especially women with schizophrenia, according to a meta-analysis that included 4.5 million people in all continents except Africa.

Why this matters

  • People with mental illness have a greater risk for cancer-related death compared with those without mental illness.

Study design

  • A meta-analysis of 46 studies focusing on any type of cancer screening in patients with mental illness (patients with mental illness, n=501,559; control individuals, n=4,216,280).
  • Funding: None.

Key results

  • Median quality of studies: 7 (interquartile range, 6-8).
  • Disparities in cancer screening were noted in patients with mental illness vs control patients (P<.001 style="list-style-type:circle;">
  • any cancer: OR, 0.76;
  • breast cancer: OR, 0.65;
  • cervical cancer: OR, 0.89; and
  • prostate cancer: OR, 0.78.
  • However, this trend was not observed for colorectal cancer (OR, 1.02; P=.75).
  • Compared with the control group, screening frequency in patients with schizophrenia was:
    • any cancer: OR, 0.62 (P<.001>
    • breast cancer: OR, 0.52 (P<.001 and>
    • cervical cancer: OR, 0.75 (P=.010).
  • Screening frequency in patients with mood disorders vs control was:
    • less likely for any (OR, 0.85) and breast (OR, 0.77; P both<.001 cancer>
    • more likely for colorectal cancer (OR, 1.18; P=.036).
  • Limitations

    • Findings should be interpreted with caution.

    Coauthored with Chitra Ravi, MPharm