How Mental Illness Affects Cervical Screening

Severe mental illness in women resulted in much lower cervical screening rates.

Cervical screening is important to catch cancer at the earliest possible stage. In women with mental illness, that could be a problem.

A study from the University of California San Francisco (UCSF) found the cervical cancer screening rate was much lower for women with mental illness than those who were mentally healthy.

young female adult_mental illness_helpWomen with mental illness are at higher risk of cervical cancer for a number of reasons. They may be more likely to engage in risky sexual behavior or to have a problem with substance abuse, which can also lead to risky sexual behavior. They are also less likely to make and keep appointments for preventive care because of their mental illness.

The senior co-authors of the study were Christina Mangurian, MD, and Dean Schillinger, MD. In a press release, Dr. Mangurian noted, “The results of this very large study indicate that we need to better prioritize cervical cancer screening for these high-risk women with severe mental illnesses.”

Dr. Mangurian is an associate professor of clinical psychiatry at UCSF and Dr. Schillinger is a UCSF professor of medicine and member of the UCSF Helen Diller Family Comprehensive Cancer Center.

Drs. Mangurian and Schillinger and colleagues analyzed data from MediCal administrative records for over 31,000 women during the period from 2010 to 2011.

They found women with severe mental illness received screening at just under half the rate of the general population of California women – 20.2 percent compared to 42.3 percent. Women aged 18 to 27 who had severe mental illness were 30 percent less likely to be screened than similar women aged 28 to 47.

Women with evidence of primary care visits were three times more likely to have been screened than those who had no evidence of primary care.

Digging deeper, the researchers found that factors associated with cervical cancer screening included age, race/ethnicity and specific mental health diagnoses. Women with schizophrenia were the least likely to be screened. The most notable factor, however, was whether women utilized primary care medical services.

The authors suggested that specialty mental health clinics might provide a venue for screening if they were the “medical home” for women with mental illness and offered on-site women’s health care.

The study was published in the April issue of Psychiatric Services.

Information on study funding and conflict of interest was not available.

University of California San Francisco, “Low cervical cancer screening rates found among mentally ill”
Psychiatric Services, “Rates of Cervical Cancer Screening Among Women With Severe Mental Illness in the Public Health System”
Written by: Beth Greenwood, RN | Medically reviewed by: Dr. Robert Carlson, M.D.