Elevated mortality risks associated with late diagnosis of cancer in individuals with psychiatric disorders?

Introduction: Considering the elevated cancer mortality in individuals with psychiatric conditions, possibly associated with late diagnosis, this study investigated cancer screening participation rates among patients under the care of four Trieste community mental health centers (CMHCs).

Methods: We conducted a retrospective cohort study on 1252 individuals with psychiatric disorders, retrieving their electronic health records up to December 2019. The study assessed participation rates in breast, cervical, and colorectal cancer screening programs. We explored differences in demographic and clinical characteristics of participants versus non-participants in screening programs.

Results: Patients with psychiatric conditions had lower screening participation rates compared to the general population of Trieste. The rates for breast and cervical cancers were approximately one-third lower, whereas the rate for colorectal cancer was halved. Psychiatric diagnosis influenced participation in breast cancer screening, with patients having anxiety disorders more likely to participate than those suffering from schizophrenia or disorders of adult personality and behavior. Age, nationality, marital status, employment status, and living situation all affected adherence to cervical cancer screening. Individuals who participated more frequently were in the 35-54 age range, of Italian nationality, employed, and had a family of their own. Conversely, non-participants were more likely to be widowed or unmarried. Finally, among patients eligible for colorectal cancer screening, those who participated were more likely to have a family of their own and have a diagnosis of affective or anxiety disorders, while those who did not adhere to the programs were more commonly widowed and had a higher frequency of diagnosis of schizophrenia or disorders of adult personality and behavior.

Conclusions: Mental health services should focus on increasing patients' participation in cancer screening programs in order to improve their physical health and reduce mortality. This intervention could contribute to promoting equitable access to preventative care and to bridging the gap between mental health and general medical services.