Women with mental illness, neuropsychiatric disability, or substance abuse run more than twice the risk of developing cervical cancer, as they are less likely to go for gynaecological smear tests, according to a study published in The Lancet Public Health.
The researchers at Karolinska Institutet, Sweden, stressed the importance of proactively approaching these women as a preventative measure against cervical cancer. The observational study included over four million women born between 1940 and 1995.
In the women, the researchers compared women diagnosed by a specialist with mental illness, neuropsychiatric disability, or substance abuse with women without such diagnoses. They then calculated the risk of cervical cancer and precancerous cervical lesions, including their participation in screening programs for cervical cancer.
"Our results suggest that women with these diagnoses participate more seldom in screening programs at the same time as they have a higher incidence of lesions in the cervix," said one of the study's first authors Kejia Hu, Institute of Environmental Medicine at Karolinska Institutet. "We thus found that they have twice the risk of developing cervical cancer," said Hu.
The greatest risk was observed for women with substance abuse, the researchers said. Women with mental illness should be made more aware of the need to undergo regular gynaecological screening, they said.
"It would lower their risk of cancer," says one of the paper's authors Karin Sundström, senior researcher at the Department of Laboratory Medicine, Karolinska Institutet.
"Similarly, if healthcare professionals are more aware of the cancer risk in these patients, they can step up preventative measures and consider how these could be delivered to potentially under-served patients," said Sundström.
One limitation of the study was that the researchers did not have full data about other risk factors for cervical cancer such as smoking, hormonal contraceptives, and sexually transmitted diseases, it said.
In May 2020, the World Health Organisation (WHO) approved a global strategy for eliminating cervical cancer as a women’s health problem. Part of the strategy is a requirement that 70 percent of women are screened for the disease at least once before age 35 and twice before age 45.
According to the researchers, inequality of care is one of the major hurdles to this objective. "Our study identified a high-risk group that needs extra attention if we're to succeed in eliminating cervical cancer," said Hu.
