Cancer Screening for the Mentally Ill

Cancer often goes undiagnosed until it spreads and undertreated in the mentally ill

(RxWiki News) Mental illness does not change the risks for cancer. Screening and treatments for cancer in the mentally ill have not been equal to those of the general population.

A recent study looked at the rates of cancer and cancer-related deaths in the mentally ill population versus the general population. While cancer occurs at about the same rates in both populations, treatment courses are not the same.

“There is a 30 percent higher case fatality rate from cancer in psychiatric patients even though their incidence of cancer is no greater than in the general population,” said the research authors.

"Get annual check-ups!"

Stephen Kisely, MD, PhD, professor of psychiatry and epidemiology at the University of Queensland in Australia, led a team to investigate cancer in people with mental illness. For the study, population-based records for the Western Australia general population were compared to psychiatric patients from 1988-2007.

Researchers found 6,586 new cancer diagnoses in psychiatric patients.

The incidence of cancer diagnoses were less in the psychiatric population compared to the general population. Ratio rates were 0.86:1 for males and 0.92:1 for females. Cancer-related deaths were higher in the psychiatric population compared to the general population. Ratio rates were 1.52:1 for men and 1.29:1 for women.

The incidence of cancer having already advanced and spread to other areas of the body, or metastasized, at the time of diagnosis was 7 percent in psychiatric patients compared to 6 percent of the general population. Psychiatric patients were less likely to receive surgery for their cancer than the general population at a ratio rate of 0.81:1.

Surgery for colorectal, breast and cervical cancers were the surgeries with the greatest disparities between the two populations.

Radiation therapy and chemotherapy for breast, colorectal and uterine cancers were less common in the psychiatric population compared to the general population.

Authors concluded, “Although the incidence is no higher than in the general population, psychiatric patients are more likely to have metastases at diagnosis and less likely to receive specialized interventions.”

“This may explain their greater fatality and highlights the need for improved cancer screening and detection.”

This study was published in December in the Archives of General Psychiatry. Funding support was provided by a grant from the Griffith Institute for Health and Medical Research. No conflicts of interest were reported.

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Review Date: 
December 19, 2012