Participation in a Swedish cervical cancer screening program among women with psychiatric diagnoses: a population-based cohort study

Abstract

Background: In Sweden, organized screening programs have significantly reduced the incidence of cervical cancer. For cancers overall, however, women with psychiatric diagnoses have lower survival rates than other women. This study explores whether women with psychiatric diagnoses participate in cervical cancer screening programs to a lesser extent than women on average, and whether there are disparities between psychiatric diagnostic groups based on grades of severity.

Methods: Between 2000 and 2010, 65,292 women within screening ages of 23-60 had at least two ICD-10 (International Statistical Classification of Diseases and Related Health Problems - Tenth Revision) codes F20*-F40* registered at visits in primary care or psychiatric care in Region Västra Götaland, Sweden. Participation in the cervical cancer screening program during 2010-2014 was compared with the general female population using logistic regression adjusted for age.

Results: Relative risk for participation (RR) for women diagnosed within psychiatric specialist care RR was 0.94 compared with the general population, adjusted for age. RR for diagnoses outside specialist care was 0.99. RR for psychoses (F20*) was 0.81.

Conclusions: Women with less-severe psychiatric diagnoses participate in the screening program to the same extent as women overall. Women who have received psychiatric specialist care participate to a lesser extent than women overall. The lowest participation rates were found among women diagnosed with psychoses.

Keywords: Cervical cancer screening participation; Equity in health; Mental illness; Pap test; Psychiatric diagnoses.