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. 2024 May;59(5):839-846.
doi: 10.1007/s00127-023-02509-w. Epub 2023 Jun 12.

Breast cancer screening participation in women using mental health services in NSW, Australia: a population study

Chris Lambeth  1   2 , Philip Burgess  3 , Jackie Curtis  4 , David Currow  5 , Grant Sara  6   7   8
Affiliations

Breast cancer screening participation in women using mental health services in NSW, Australia: a population study

Chris Lambeth et al. Soc Psychiatry Psychiatr Epidemiol. 2024 May.

Abstract

Purpose: Population screening programs have contributed to reduced breast cancer mortality, but disadvantaged or vulnerable groups may not have shared these improvements. In North American and European studies, women living with mental health conditions have reduced breast screening rates. There are no current Australasian data to support health system planning and improvement strategies.

Methods: The New South Wales (NSW) BreastScreen program offers free screening to NSW women aged 50-74. We compared 2-year breast screening rates for mental health service users (n = 33,951) and other NSW women (n = 1,051,495) in this target age range, after standardisation for age, socioeconomic status and region of residence. Mental health service contacts were identified through linkage to hospital and community mental health data.

Results: Only 30.3% of mental health service users participated in breast screening, compared with 52.7% of other NSW women (crude incidence rate ratio 0.57, 95% CI 0.56-0.59). Standardisation for age, socioeconomic disadvantage or rural residence did not alter this screening gap. Around 7000 fewer women received screening than would be expected from comparable population rates. Screening gaps were largest in women over 60 and in socioeconomically advantaged areas. Women with severe or persistent mental illness had slightly higher screening rates than other mental health service users.

Conclusions: Low breast cancer screening participation rates for NSW mental health service users suggest significant risk of later detection, possibly leading to more extensive treatment and premature mortality. Focussed strategies are needed to support greater breast screening participation for NSW women who use mental health services.

Keywords: Breast cancer; Depression; Mammography; Mental illness; Schizophrenia; Screening.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study flowchart and participant numbers
Fig. 2
Fig. 2
Breast screening participation rates, by age group, rurality and socioeconomic disadvantage, comparing NSW mental health service users aged 50–74 to other NSW women of the same age
See this image and copyright information in PMC

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