Bridging the Gap: Interventions to Increase Cancer Screening Adherence in Individuals with Mental Disorders-A Systematic Review

Abstract

Patients with mental illnesses adhere to organized cancer screening programs less frequently than the general population. This systematic review aims to examine the literature to identify studies that evaluate interventions designed to increase cancer screening adherence in people with mental disorders. The review protocol was registered (CRD42024510431) and Pubmed and Scopus were searched up to January 2024. Breast, colorectal, or cervical cancer screening were considered. We adhered to the PROSPERO guidelines. Study quality was assessed. Overall, six articles were included: two RCT studies, two before-after studies, and two cohort studies. Four interventions were conducted in the USA, one in Canada, and one in Japan. Two studies evaluated all three cancer screening programs, two studies evaluated breast cancer screenings, and two studies evaluated colorectal cancer screenings. The proposed interventions included patient navigation, case management, and support from staff members along with educational modules, decision counselling sessions, and enhanced primary care. The most consistent improvements in screening adherence were observed in breast and colorectal cancer screenings compared to usual care, particularly through interventions like patient navigation (colorectal cancer: 47.1% vs. 11.8%, p < 0.001) and case management. Further evaluations of interventions and their costs are still needed.

Keywords: RCT; mental illness; oncological screening; psychiatric; screening behavior; screening program; screening uptake.

Figure 1

Fishbone diagram or Ishikawa diagram to synthesize issues surrounding cancer screening in people with mental illnesses and the solution to the problem.

Figure 2

PRISMA flow diagram of the review process.