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Cited by 64Global Cancer Incidence and ScreeningMental Health Treatment and AccessHealth Promotion and Cardiovascular Prevention

Cancer Screening Among Adults With and Without Serious Mental Illness: A Mixed Methods Study

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Murphy, Karly A., Stone, Elizabeth M., Presskreischer, Rachel, McGinty, Emma E., Daumit, Gail L., Pollack, Craig E.·2021·Medical Care
DOI 10.1097/mlr.0000000000001499PMC PMC7952680
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Abstract

Background: Persons with serious mental illness (SMI) die 10–20 years earlier than the general population; cancer is the second leading cause of death. Differences in cancer screening between SMI and the general population are not well understood. Objectives: To describe receipt of cancer screening among individuals with versus without SMI and to explore clinicians’ perceptions around cancer screening for people with SMI. Methods: Mixed-methods study using 2010–2017 MarketScan commercial insurance administrative claims data and semi-structured clinician interviews. In the quantitative analyses, we used multivariate logistic regression analyses to calculate the likelihood of receiving cervical, breast, colorectal, or prostate cancer screening among people with versus without SMI, defined as schizophrenia or bipolar disorder. We conducted semi-structured interviews with 17 primary care physicians and 15 psychiatrists. Interview transcripts were coded using a hybrid deductive/inductive approach. Results: Relative to those without SMI, individuals with SMI were less likely to receive screening for cervical cancer [adjusted odds ratio (aOR): 0.80; 95% confidence interval (CI): 0.80–0.81], breast cancer (aOR: 0.79; 95% CI: 0.78–0.80), colorectal cancer (aOR: 0.90; 95% CI: 0.89–0.91), and prostate cancer (aOR: 0.85; 95% CI: 0.84–0.87). Clinicians identified 5 themes that may help explain the lower rates of cancer screening in persons with SMI: access to care, available support, prioritization of other issues, communication, and patient concerns. Conclusions: People with SMI were less likely to receive 4 common types of cancer screening. Improving cancer screening rates in the SMI population will likely require a multidisciplinary approach to overcome barriers to screening.

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  • Algorithms trained on biased data often replicate and magnify inequalities present in their source material, disproportionately disadvantaging marginalized groups.

    “Algorithms trained on biased data often replicate and magnify the inequalities present in their source material, disproportionately disadvantaging marginalized groups [[6], [7], [8]].”

    From Frameworks encompassing intersectional perspective of artificial intelligence in healthcare. Scoping review (2026) · cites this paper as [6]

    The Discussion (page unavailable) reports disparities in cancer screening among people with serious mental illness, not disparities produced by algorithms. Searches for biased training data and algorithmic bias found no passage addressing the attributed claim. (LLM, conf=0.76)

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Research works printed but not linked: 27

  1. [1]Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing chronic disease. 2006; 3(2): A42. 16539783 PMC1563985
  2. [2]Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Archives of general psychiatry. 2007; 64(10): 1123– 1131. 17909124
  3. [3]Olfson M, Gerhard T, Huang C, Crystal S, Stroup TS. Premature Mortality Among Adults With Schizophrenia in the United States. JAMA psychiatry. 2015; 72(12): 1172– 1181. 26509694
  4. [5]Dickerson F, Schroeder J, Katsafanas E, Cigarette Smoking by Patients With Serious Mental Illness, 1999–2016: An Increasing Disparity. Psychiatr Serv. 2018; 69(2): 147– 153. 28945183
  5. [6]Daumit GL, Anthony CB, Ford DE, Pattern of mortality in a sample of Maryland residents with severe mental illness. Psychiatry research. 2010; 176(2–3): 242– 245. 20207013 PMC2966471
  6. [7]Mangurian C, Newcomer JW, Modlin C, Schillinger D. Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review. Journal of General Internal Medicine. 2016; 31(9): 1083– 1091. 27149967 PMC4978675
  7. [12]Tilbrook D, Polsky J, Lofters A. Are women with psychosis receiving adequate cervical cancer screening? Can Fam Physician. 2010; 56(4): 358– 363. 20393098 PMC2860833
  8. [13]Xiong GL, Bermudes RA, Torres SN, Hales RE. U se of cancer-screening services among persons with serious mental illness in Sacramento County. Psychiatr Serv. 2008; 59(8): 929– 932. 18678693
  9. [14]Thomas M, James M, Vittinghoff E, Creasman JM, Schillinger D, Mangurian C. Mammography Among Women With Severe Mental Illness: Exploring Disparities Through a Large Retrospective Cohort Study. Psychiatr Serv. 2018; 69(1): 48– 54. 28945184
  10. [15]James M, Thomas M, Frolov L, Rates of Cervical Cancer Screening Among Women With Severe Mental Illness in the Public Health System. Psychiatr Serv. 2017; 68(8): 839– 842. 28412897
  11. [16]Salsberry PJ, Chipps E, Kennedy C. Use of general medical services among Medicaid patients with severe and persistent mental illness. Psychiatr Serv. 2005; 56(4): 458– 462. 15812097
  12. [17]Abrams MT, Myers CS, Feldman SM, Cervical cancer screening and acute care visits among Medicaid enrollees with mental and substance use disorders. Psychiatr Serv. 2012; 63(8): 815– 822. 22660581 PMC3631005
  13. [18]Domino ME, Beadles CA, Lichstein JC, Heterogeneity in the quality of care for patients with multiple chronic conditions by psychiatric comorbidity. Med Care. 2014; 52 Suppl 3: S101– 109. 24561748
  14. [20]Druss BG, Rosenheck RA, Desai MM, Perlin JB. Quality of preventive medical care for patients with mental disorders. Med Care. 2002; 40(2): 129– 136. 11802085
  15. [21]Kaufman EA, McDonell MG, Cristofalo MA, Ries RK. Exploring barriers to primary care for patients with severe mental illness: frontline patient and provider accounts. Issues Ment Health Nurs. 2012; 33(3): 172– 180. 22364429
  16. [22]Mojtabai R, Cullen B, Everett A, Reasons for not seeking general medical care among individuals with serious mental illness. Psychiatr Serv. 2014; 65(6): 818– 821. 24733659
  17. [24]Stumbo SP, Yarborough BJH, Yarborough MT, Green CA. Perspectives on Providing And Receiving Preventive Health Care From Primary Care Providers and Their Patients With Mental Illnesses. Am J Health Promot. 2018; 32(8): 1730– 1739. 29658287 PMC7220499
  18. [25]Irwin KE, Park ER, Fields LE, Bridge: Person-Centered Collaborative Care for Patients with Serious Mental Illness and Cancer. The oncologist. 2019; 24(7): 901– 910. 30696722 PMC6656464
  19. [26]Schoen C, DesRoches C. Uninsured and unstably insured: the importance of continuous insurance coverage. Health Serv Res. 2000; 35(1 Pt 2): 187– 206. 10778809 PMC1089095
  20. [27]Foerster B, Pozo C, Abufaraj M, Association of Smoking Status With Recurrence, Metastasis, and Mortality Among Patients With Localized Prostate Cancer Undergoing Prostatectomy or Radiotherapy: A Systematic Review and Meta-analysis. JAMA Oncol. 2018; 4(7): 953– 961. 29800115 PMC6145736
  21. [28]Dess RT, Hartman HE, Mahal BA, Association of Black Race With Prostate Cancer-Specific and Other-Cause Mortality. JAMA Oncol. 2019; 5(7): 975– 983. 31120534 PMC6547116
  22. [29]Pearson SD, Katzelnick DJ, Simon GE, Manning WG, Helstad CP, Henk HJ. Depression among high utilizers of medical care. Journal of General Internal Medicine. 1999; 14(8): 461– 468. 10491229 PMC1496724
  23. [30]Smeets RGM, Elissen AMJ, Kroese MEAL, Hameleers N, Ruwaard D. Identifying subgroups of high-need, high-cost, chronically ill patients in primary care: A latent class analysis. PloS one. 2020; 15(1): e0228103. 31995630 PMC6988945
  24. [31]Coffey A, Atkinson P. Making Sense of Qualitative Data: Complementary Research Strategie. Thousand Oaks, CA: Sage Publications; 1996.
  25. [32]Solmi M, Firth J, Miola A, Disparities in cancer screening in people with mental illness across the world versus the general population: prevalence and comparative meta-analysis including 4 717 839 people. The lancet Psychiatry. 2020; 7(1): 52– 63. 31787585
  26. [34]Velligan DI, Bow-Thomas CC, Huntzinger C, Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatients with schizophrenia. Am J Psychiatry. 2000; 157(8): 1317– 1323. 10910797
  27. [35]Murphy KA, Daumit GL, Bandara SN, Association Between the Maryland Medicaid Behavioral Health Home Program and Cancer Screening in People With Serious Mental Illness. Psychiatr Serv. 2020: appips201900299. PMC7266726 32019432

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Authors
Murphy, K. A., Stone, E. M., Presskreischer, R., McGinty, E. E., Daumit, G. L., & Pollack, C. E.
Affiliations
  • Johns Hopkins University (US)
  • Health Policy and Management
Corresponding author
  • Murphy, Karly A.
  • Daumit, Gail L.
  • Pollack, Craig E.
ORCID
Venue
Medical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2021-01-20
Volume
59
Issue
4
Pages
327-333
ISSN
0025-7079 (ISSN-L)
DOI
10.1097/mlr.0000000000001499
PMC
PMC7952680
OpenAlex
W3123245422
Cited by
64
References
5
Citations by year
2026: 15 · 2025: 18 · 2024: 11 · 2023: 9 · 2022: 7 · 2021: 3
FWCI
2.73
Type
journal article
Language
en
Open access
Locations
  • Medical Care (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5t32hl007180-45)
  • National Heart, Lung, and Blood Institute (T32-HL-007180)
  • National Institute of Mental Health (K01MH106631, T32MH109436, P50MH115842)
Topics
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
cancer screening, severe mental illness, schizophrenia, bipolar disorder, cervical cancer screening, breast cancer screening, colorectal cancer screening, prostate cancer screening, clinician perceptions, health care access, barriers to screening, health disparities
MeSH terms
Adult, Mental Disorders, Breast Neoplasms, Uterine Cervical Neoplasms, Communication, Female, Health Services Accessibility, Humans, Insurance Claim Review, Male, Middle Aged, Neoplasms, Prostatic Neoplasms, Retrospective Studies, Severity of Illness Index, Socioeconomic Factors, Colorectal Neoplasms, Comorbidity, Logistic Models, Early Detection of Cancer, Young Adult

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