Women with serious mental illness are less likely to receive cancer screenings

Women with symptoms of serious mental illness are significantly less likely to receive the three routine cancer screenings of Pap tests, mammography, and clinical breast examinations than women in the general population. This is despite their elevated risk for medical comorbidities and early death, a new study indicates.

Women who reported symptoms of serious psychological distress, such as feelings of hopelessness and depression, during the past 30 days were 41% less likely to have received Pap tests during the preceding 2-year period, found University of Illinois researcher and doctoral student Xiaoling Xiang, MPhil. Her findings were published in Women's Health Issues (2014; doi:10.1016/j.whi.2014.09.0010).

These women also were 38% and 35% less likely to have undergone mammography and clinical breast examination, respectively, during that same period of time.

Xiang examined 3 years of data for more than 17,000 women who participated in the US Department of Health and Human Services' Medical Expenditure Panel Survey.

More than 1,300 women in the sample, who ranged in age from 40 to 74 years, had symptoms of serious psychological distress, an indicator of mental illness that is serious enough to cause significant impairment and require treatment.

Prior research has suggested that the mentally ill tend to utilize outpatient, inpatient, and emergency services at much higher rates than the general population.

“However, people with serious mental illness are estimated to die an average of 14 to 32 years earlier than the average person,” said Xiang, a doctoral candidate in social work. “There's a big health disparity there. Their frequent contact with the health care system opens up opportunities for providers to implement targeted interventions and patient education to improve utilization of preventive services.”

The higher mortality rates among the mentally ill, despite their greater use of certain types of medical services, may point to a quality of care problem, Xiang explained. “If you have to use the emergency room multiple times each year, but you're not receiving routine screenings and other preventive care, it might be because your health care needs are not being adequately met.”

Xiang's data analyses on her sample confirmed prior research findings that women with symptoms of serious psychological distress have double or triple the rates of chronic lung disease, heart disease, and diabetes as the general population.

Severe mental illness also sometimes leads to self-neglect and underreporting of physical symptoms, and can make it difficult for patients to discuss their needs with their physicians. Likewise, bias and stigmatization of the mentally ill by health care practitioners can discourage some patients from seeking care.

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