Review and special articleDisparities in Breast and Cervical Cancer Screening in Women with Mental Illness: A Systematic Literature Review
Section snippets
Context
In 2012, there will be an estimated 241,230 new cases and 44,140 deaths attributed to breast and cervical cancer.1 To combat this morbidity and mortality, the current national guidelines for breast and cervical cancer screening in women aim to detect cancer at an early stage.2, 3, 4 In 2010, the screening mammography rates within the prior 2 years for women aged ≥40 years ranged from 49.1% to 78.2%. In that same period, 54.1%–77.8% of women aged ≥18 years reported having a Pap for cervical
Evidence Acquisition
A systematic, limited review of the literature was conducted and a critical appraisal was made of selected articles believed to contain material that would provide evidence of cancer screening rates among the mentally ill. The consecutive steps of the methods used during this review process are summarized in Figure 2 and briefly described below.
Evidence Synthesis
Among the articles selected, 15 studies were from the U.S., and four were from Europe, Canada, or Australia. Two articles addressed cervical cancer screening, eight addressed breast cancer screening, and nine addressed both cancers. The sample size of these studies varied from 26 participants to a larger national data set of 335,294 participants. The studies included were prospective (n=9) and retrospective studies (n=10); small clinical practice (n=7) and larger national database analyses (n
Discussion
Substantial primary evidence was found that suggests that important disparities persist in breast and cervical cancer screening utilization among women with chronic mental illness. Cancer screening prevalence for these women lags behind that for women without mental illness, which has improved over the past decade, and that barriers to screening specific to the mentally ill may exist. A few studies investigated specific barriers to or factors that promote screening among women with mental
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