270092 Cancer screening disparities among women with severe mental illness

Wednesday, October 31, 2012 : 9:10 AM - 9:30 AM

Todd M. Bear, MPH , Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA
Patricia Documét, MD, DrPH , Behavioral and Community Health Sciences, University of Pittsburgh, Pitsburgh, PA
Jeanette M. Trauth, PhD , Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA
Edmund Ricci, PhD, MLitt , Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
Background: Cancer mortality rates are higher among people with mental illness, compared to the general population. One explanation for this disparity is the underutilization of preventive services, particularly cancer screening, by persons with mental illness. Objective: To examine the relationship between serious mental illness (SMI) and noncompliance with the American Cancer Society's (ACS) recommendations for Mammogram (MAM), Clinical Breast Exam (CBE), and Pap Test (PAP). Methods: Data from women age 20 and older (n=3260) who responded to the Allegheny County Behavioral Risk Factor Surveillance Survey, a population based, random digit dial survey, was used to determine screening noncompliance according to ACS guidelines based on age and time of most recent MAM, CBE and PAP. Both bivariate and multivariate logistic regressions were used to test associations between SMI and screening noncompliance. SMI was measured using the validated Kessler 6 scale (a score of >=13 was used to indicate SMI). Results: In bivariate analyses SMI was significantly associated with screening noncompliance for MAM (OR=2.29; 95CI=1.51,3.49), marginally significant for CBE (OR=1.43; 95CI=0.98,2.08), and non-significant for PAP (OR=1.30; 95CI=0.69,2.46). In multivariate analyses, controlling for age, race, household income, education, and insurance, MAM (OR=2.00; 95CI=1.29,3.09) and CBE (OR=1.56; 95CI=1.07,2.29) remained significant. Conclusions: Underutilization of preventive services by women with SMI may lead to delayed diagnosis and treatment and ultimately to worse health outcomes. Integration of physical and mental health care services and interventions aimed at increasing cancer screening in women with SMI may help to eliminate disparities in cancer screening and mortality.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe cancer screening disparities among women with serious mental illness by age, race, education and household income. Discuss possible reasons for why cancer screening disparity exists and identify areas for intervention.

Keywords: Cancer Screening, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in the field of psychology for over ten years, first as a therapist and research assistant at Western Psychiatric Institute and Clinic and then as a project coordinator in the Department of Psychology at the University of Pittsburgh. I have received my MPH in Behavioral and Community Health Sciences and I'm near completion of my doctoral training. I have extensive training in the implementation of surveys and the analysis of survey data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.