Association between serious psychological distress and nonparticipation in cancer screening and the modifying effect of socioeconomic status: Analysis of anonymized data from a national cross‐sectional survey in Japan

Abstract

BACKGROUND It is unclear whether individuals who have serious psychological distress (SPD) are less likely to participate in screening tests for gastric cancer, lung cancer, and other types of cancer. Of the few studies that have examined the association between SPD and participation in cancer screening, none have reported modifying effects of educational, marital, or employment status. METHODS The authors analyzed a national representative data set from the 2010 Comprehensive Survey of Living Conditions of Japan., including individuals aged <69 years who met the national program criteria for each type of cancer screening (colorectal, gastric, and lung cancers, n = 29,926; breast cancer, n = 15,423; and cervical cancer, n = 24,735). SPD was defined as a score of 13 or greater on the Kessler 6 scale. Logistic regression analyses were conducted to examine the association between SPD and participation in cancer screening, and multivariate analyses stratified by socioeconomic status also were conducted. RESULTS SPD was significantly associated with a lower odds ratio (OR) for participation in screening for colorectal cancer (OR, 0.743; 95% confidence interval [CI], 0.638‐0.866), gastric cancer (OR, 0.823; 95% CI, 0.717‐0.946), and lung cancer (OR, 0.691; 95% CI, 0.592‐0.807). Only educational status significantly modified the effect of SPD on participation in these 3 types of cancer screening (P < .05). CONCLUSIONS Individuals with SPD, especially those with lower education levels, were less likely to participate in screening for colorectal, gastric, and lung cancers. Individuals with SPD should be encouraged and supported to participate in cancer screening tests. Cancer 2018;124:555‐62. © 2017 American Cancer Society.

Cancer care for people with mental disorders: A qualitative survey among cancer care and psychiatric care professionals in Japan

“…People with mental disorders often experience problems such as lack of exercise, 26,27 poor eating habits, 26,28 obesity, 28,29 high rates of smoking or substance abuse, 26,[30][31][32][33][34] and low cancer-screening rates. [9][10][11][12] Consistent with previous papers, [19][20][21][22][23] the present study showed that these patients need support in the prevention and early detection of cancer.…”

The Psychological Impact of Referral for Mammography Screening for Breast Cancer Among Women in Muscat Governorate: A cross-sectional study

“…found a positive correlation between the perceived risk and a family history of cancer in men screened for prostate carcinoma and that these men had a particularly high level of psychological distress 17. In a study by Fujiwara et al ., the level of education of participants with serious psychological distress significantly increased their willingness to participate in cancer screening 16. However, in the current study, education level of the participants had no significant effect on the PCQ results.…”

“…This finding might be due to the fact that younger women are more aware of disease consequences and treatments available 15. Several other studies have also shown an inverse relationship between age and psychological outcomes 16…”

Association between socioeconomic factors at diagnosis and survival in breast cancer: A population‐based study

“…Higher education tends to be associated with less manual labor (fewer physical activities), stressful work, late age at first birth, and null parity, factors known to increase the incidence of breast cancer, whereas cervical cancer is largely caused by infection with human papillary virus, which might explain the difference between the impact of education on the incidence rates of these two cancers . Interestingly, while education level could modify the effect of psychological distress on accepting screening for colorectal and lung cancers, it did not exhibit this effect on breast cancer screening in countries with low cancer screening rates . From the perspective of survival, our study supported education as a protective factor for BCSS and OS (Table ), which was consistent with results of previous studies in which women with high education levels had better survival than women with low education levels, which suggests that education helps women understand the benefits of conducting breast self‐examination and accepting routine breast cancer screening programs, and it can improve patient access to effective treatments .…”