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Cervical and breast cancer screening uptake among women with serious mental illness: A data linkage study

Woodhead, Charlotte, Cunningham, Ruth, Ashworth, Mark, Barley, Elizabeth, 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).

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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. © 2016 The Author(s).

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
Woodhead, Charlotte
Cunningham, Ruth
Ashworth, Mark
Stewart, Robert J.
Henderson, Max J.
Date : 21 October 2016
Funders : MRC MPHiL
DOI : 10.1186/s12885-016-2842-8
Copyright Disclaimer : © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, 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 ( applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords : Breast cancer, Cancer screening, Cervical cancer, Data linkage, Mammography, Psychoses, Serious mental illness,
Depositing User : Diane Maxfield
Date Deposited : 28 Mar 2019 16:14
Last Modified : 28 Mar 2019 16:14

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