Cancer diagnosis in people with severe mental illness: practical and ethical issues

Interventions to encourage uptake of cancer screening for people with severe mental illness

“…Some studies have reported an increased incidence of cancer in people with SMI, although data are conflicting (Howard 2010;Leucht 2007). This may be due to lack of consideration by researchers of the influence of missing cancer diagnoses, shortened life expectancy, historical and health service contexts, behavioural risk factors and genetic or drug effects (Howard 2010). However, SMI is associated with certain adverse health behaviours and health problems (Brown 1999), including obesity (Allison 1999), smoking (Dalack 1998;McReadie 2002), drinking (McReadie 2002 and poor diet (Osborn 2007) which predispose individuals to cancer, especially lung and breast cancer (Howard 2010).…”

“…People with schizophrenia (and related non-organic psychotic disorders) and bipolar disorder involving prolonged treatment and disability or dysfunction are considered to have severe mental illness (SMI) (Howard 2010;Ruggeri 2000). Schizophrenia is characterised by distortions of thinking and perception, often accompanied by delusions, hallucinations and blunting or incongruity of emotional responses.…”

“…Cancer is a leading cause of death worldwide, accounting for approximately 13% of all deaths in 2007 (WHO 2009). Some studies have reported an increased incidence of cancer in people with SMI, although data are conflicting (Howard 2010;Leucht 2007). This may be due to lack of consideration by researchers of the influence of missing cancer diagnoses, shortened life expectancy, historical and health service contexts, behavioural risk factors and genetic or drug effects (Howard 2010).…”

“…This may be due to lack of consideration by researchers of the influence of missing cancer diagnoses, shortened life expectancy, historical and health service contexts, behavioural risk factors and genetic or drug effects (Howard 2010). However, SMI is associated with certain adverse health behaviours and health problems (Brown 1999), including obesity (Allison 1999), smoking (Dalack 1998;McReadie 2002), drinking (McReadie 2002 and poor diet (Osborn 2007) which predispose individuals to cancer, especially lung and breast cancer (Howard 2010). Cancer screening (the systematic application of a test in an asymptomatic population in order to identify individuals with an abnormality suggestive of a specific cancer) (WHO 2007), is associated with reduced rates of morbidity and mortality (Anttila 2004;Botha 2003;Draisma 2003;Rhodes 2000).…”

“…Many countries offer screening routinely for a wide range of cancers including cervical (Anttila 2004), prostate (Draisma 2003), breast (Botha 2003) and colorectal (Rhodes 2000). However, a recent review (Howard 2010), which identified 12 studies (conducted in Iceland, USA, Canada, Australia, and the UK) of cancer screening uptake in people with mental illness, concluded that adults with SMI were less likely than other groups to receive screening for a range of cancers (i.e. cervical, breast, colorectal, and prostate cancer) .…”