Woodhead, Charlotte, Cunningham, Ruth, Ashworth, Mark, Barley, Elizabeth ORCID: https://orcid.org/0000-0001-9955-0384, Stewart, Robert J. and Henderson, Max J. (2016) Cervical and breast cancer screening uptake among women with serious mental illness: a data linkage study. BMC Cancer, 16 (1). p. 819. ISSN 1471-2407

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Abstract

Background
Breast and cancer screening uptake has been found to be lower among women with serious mental illness (SMI). This study aims to corroborate these findings in the UK and to identify variation in screening uptake by illness/treatment factors, and primary care consultation frequency.

Methods
Linked population-based primary and secondary care data from the London borough of Lambeth (UK) were used to compare breast and cervical screening receipt among linked eligible SMI patients (n = 625 and n = 1393), to those without SMI known only to primary care (n = 106,554 and n = 25,385) using logistic regression models adjusted first for socio-demographic factors and second, additionally for primary care consultation frequency.

Results
Eligible SMI patients were less likely to have received breast (adjusted odds ratio (OR) 0.69, 95 % confidence interval (CI), 0.57 - 0.84, p < 0.001) or cervical screening (adjusted OR 0.72, CI: 0.60 - 0.85, p < 0.001). Schizophrenia diagnosis, depot injectable antipsychotic prescription, and illness severity and risk were associated with the lowest odds of uptake of breast (adjusted ORs 0.46 to 0.59, all p < 0.001) and cervical screening (adjusted ORs 0.48 - 0.65, all p < 0.001). Adjustments for consultation frequency further reduced effect sizes for all subgroups of SMI patient, in particular for cervical screening.

Conclusions
Women with SMI are less likely to receive breast and cervical cancer screening than comparable women without SMI. Higher primary care consultation rates among SMI patients is likely a mediating factor between SMI status and uptake, particularly for cervical screening - a service organised in primary care. To tackle health disparities linked to SMI, efforts at increasing screening uptake are key and should be targeted at women with other markers of illness severity or risk, beyond SMI status alone.

Item Type:	Article
Identifier:	10.1186/s12885-016-2842-8
Additional Information:	CW was funded by the MRC Mental and Physical Health in Lambeth grant (MR/J013471/1). MA is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London (KCL). RS is partfunded by the NIHR BRC and Dementia Biomedical Research Unit at South London and Maudsley NHS Foundation Trust and KCL. CRIS is supported by the NIHR BRC for Mental Health BRC Nucleus at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience (IOPPN), KCL, jointly funded by the Guy’s and St Thomas’ Trustees and the South London and Maudsley Trustees. RC was funded by the New Zealand Federation of Graduate Women and the Health Research Council of New Zealand © 2016 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords:	Cancer screening; Breast cancer; Cervical cancer; Mammography; Psychoses; Serious mental illness; Data linkage
Subjects:	Medicine and health > Mental health Medicine and health
Depositing User:	Elizabeth Barley
Date Deposited:	01 Nov 2016 09:59
Last Modified:	04 Nov 2024 12:16
URI:	https://repository.uwl.ac.uk/id/eprint/2942

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