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People with severe mental illness (SMI) are less likely to attend cancer screening, which causes cancer to be diagnosed at a later stage, reducing treatment options.
This could be a contributing factor as to why people with SMI are two and half times more likely to die prematurely from cancer than their peers, according to researchers who led the investigation.
Greatest disparity seen in bowel cancer screening participation
The study, published in the British Journal of Cancer, analysed data from patient records at more than 1,000 general practices in England.
It found that screening participation was lower for people with SMI for all three national cancer screening programmes – breast, bowel and cervical. In total:
- 42% of people with SMI attended bowel cancer screening, compared to 59% of people without
- 48% of people with SMI attended breast cancer screening, compared to 60% of people without
- 64% of people with SMI attended cervical cancer screening, compared to 70% of people without.
Attendance also varied depending on the region in which people lived, with people with SMI in the most deprived areas of the country less likely to attend a screening compared to the most affluent areas.
Different groups experienced greater barriers to cancer screening than others
There were also pronounced differences between mental health conditions, with people with schizophrenia least likely to attend a screening, following by those diagnosed with other psychoses and bipolar disorder.
Furthermore, participation in bowel cancer screening was lower among Black adults with SMI compared with white adults (35% vs 44%), and the same was true for Black adults compared to white adults without SMI (48% vs 62%).
Dr Ian Walker, Cancer Research UK’s executive director of policy and information says the research not only exposes concerning barriers to participating in cancer screening faced by people with SMI, but also “crucially shows where these disparities persist across ethnic minority groups and in more deprived areas”.
“It’s vital that we work with individuals and communities to build targeted interventions that ensure everyone benefits equally from programmes that diagnose cancer early and, ultimately, save lives,” he added.
More research needed to discover why some groups are less likely to attend screenings
Karis Betts, senior health information manager at Cancer Research UK says these barriers to screening can be “emotional, cultural or practical” and more research is now needed to guide the government, the NHS and local authorities in tackling health inequalities experienced by different groups.
The authors of the study are heeding the same message, and Dr Robert Kerrison, lead author of the study and co-lead of the Cancer Care group at the University of Surrey said: “We now need to learn more about why participation rates are lower for these individuals, so that medical professionals can tailor support and make it easier for people with severe mental illness to attend.”