Mental Health Issues Barrier to Breast, Cervical Cancer Screenings

New research has revealed that women with serious mental health problems are less likely to undergo screenings for breast cancer and cervical cancer. Given that one in four Americans suffers from some type of mental illness and that cancer is the second-leading cause of death in this country, this confluence is noteworthy and should function as a wakeup call for the medical profession. In her Women’s Health Issue article titled “Serious Psychological Distress as a Barrier to Cancer Screening Among Women,” University of Illinois professor Xiaoling Xiang disclosed the results of a study she performed using data collected from the U.S. Department of Health and Human Services. In its exhaustive 2007-2011 Medical Expenditure Panel Survey, the DHHS found more than 1,300 women between the ages of 40 and 74 who exhibited symptoms of significant psychological disturbance. The information obtained in the survey was highly detailed and allowed Xiang to establish a clear relationship between mental illness and a failure to keep up with cancer screening recommendations. Xiang found that in comparison to their peers, women suffering from serious psychological distress were 41 percent less likely to have had Pap smears (for cervical cancer), 38 percent less likely to have had mammograms and 35 percent less likely to have had clinical exams for breast cancer within the standard time frame recommended by doctors. In total, 72 percent, 60 percent and 68 percent of mentally ill women were up-to-date on their Pap smears, mammograms and clinical breast cancer exams respectively, while the numbers were 85 percent, 76 percent and 82 percent for women without a negative mental health diagnosis.

When Preventive Healthcare Is Lacking

People with mental health disorders have higher rates of physical disease in general, and doctors usually check carefully to make sure patients with known psychological issues aren’t neglecting other areas of their health. But preventive medical care can be a challenge with mentally ill patients, since even the most attentive and caring healthcare providers can’t keep track of everything. If patients, or responsible family members, don’t take the initiative to make appointments for preventive exams, there is a very good chance they won’t take place. Studies have shown that mental illness is not a risk factor for most types of cancers. However, it does tend to delay diagnosis until more advanced stages, thereby leading to higher mortality rates. When the disease involved is cancer, preventive medicine can and does make a significant difference. Pap smears have helped cut cervical cancer deaths by over 50 percent in the last 30 years, while mammograms and clinical exams for breast cancer can alert women to the presence of a dangerous and potentially life-threatening condition. There is some controversy about whether mammograms alone actually save a significant number of lives. But breast cancer kills more than 40,000 women in the United States each year, and it is clear that any early warning a possible victim has will give her the opportunity to make important choices about how to confront her illness. People with mental illness live about 25 years less, on average, than those without such conditions. This suggests their visits with doctors and interactions with the healthcare system are not as effective and targeted to relevant threats as they should be. Room for improvement obviously exists, and more comprehensive preventive healthcare could impact this statistic in a significant way. Xiaoling Xiang hopes her findings will lead to changes in medical treatment regimens for women with psychological disorders. Instead of waiting for them to ask for cancer screenings, doctors need to recommend—and schedule—such tests, never assuming anything or depending on responsible family members to take the initiative.

Physical Activity Affects Screening Rates

It is important to note that most of the psychologically distressed women studied in the Department of Health and Human Services survey had been keeping up with their breast and cervical cancer screenings. Percentages were lower than average, but for each of the three tests studied, more than six in 10 mentally ill women were up-to-date. Among these women, the common factors were having a consistent place to receive care, being physically active and having a higher number of previous-year medical appointments. So it seems that when women are health-conscious and work with medical professionals who know them well, the chances of preventive medical needs being neglected are reduced. Professor Xiang’s research didn’t touch on it, but it seems likely these factors help psychologically distressed women maintain their physical health in general. As such, they could provide a blueprint for sensible preventive medicine for mentally ill women, the healthcare professionals who treat them and the friends and family who look out for their welfare.

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