[Feasibility of using municipal data to assess cancer screening uptake rates among people with severe mental illness in Japan].

Abstract

Objectives　This study examined the availability and readiness of municipal data to assess participation in cancer screening among people with severe mental illness (SMI). In addition, we evaluated the feasibility of linking the Medical Payment for Services and Supports for Persons with Disabilities (MPSS) database and the municipal cancer screening database to calculate cancer screening uptake rates among individuals with schizophrenia spectrum disorder.Methods　A two-phase survey was conducted in municipalities in the Kinki, Chugoku, and Shikoku regions of Japan. In Phase 1, municipalities completed a questionnaire on the digitization status of relevant data items in municipal databases, including the MPSS, Mental Disability Certificate (MDC), and municipal cancer screening databases. In Phase 2, municipalities completed a questionnaire assessing the feasibility of generating aggregated data on cancer-screening participation using the MPSS and municipal cancer-screening databases.Results　Of the 429 municipalities surveyed, 67 (15.6%) responded to Phase 1. Of these, approximately 90% of the municipalities managed the MPSS and MDC databases as electronic data files; however, among those using electronic systems, primary diagnoses coded using the International Classification of Diseases, 10th Revision (ICD-10) were recorded in only 45% and 34% of the MPSS MDC databases, respectively. The municipal cancer screening database was electronically managed in over 95% of the participating municipalities. Primary screening results were recorded in 99% of patients, and attendance at follow-up examinations was recorded in ＞ 94% of patients. In the Phase 2 questionnaire, 13 municipalities (3.0%) successfully provided aggregated data by linking the MPSS and municipal cancer-screening databases, enabling the calculation of the municipal cancer-screening uptake rate among individuals with schizophrenia spectrum disorders. However, barriers included missing diagnostic information, technical difficulties in linking data across systems, privacy and data governance concerns, and limited human resources.Conclusion　Assessing cancer-screening uptake rates among people with SMI using the MPSS and municipal cancer-screening databases is technically feasible in a subset of municipalities. However, several challenges remain including limitations in data item completeness, structural barriers between information systems, and human resource constraints. Continued standardization of local government information systems and improvements in the administrative data infrastructure may enable the use of municipal data to design and evaluate cancer-screening policies that are responsive to the needs of people with SMI.