Newswise — A recent research conducted by Aarhus University reveals a concerning trend where a significant number of individuals facing psychological challenges are declining opportunities for colorectal cancer screening. This poses a problem considering the elevated mortality rates for Danish individuals with mental illnesses who develop cancer.
Colorectal cancer affects approximately 5,000 Danes annually, with a higher prevalence among those aged 50-74. In an effort to detect this type of cancer at an early stage, all individuals within this age range are provided with free screening opportunities. Regrettably, not everyone seizes this offer, and individuals with mental health issues, in particular, exhibit lower acceptance rates. These findings, now published in the esteemed journal The Lancet Psychiatry, are derived from a study conducted by the Department of Clinical Medicine at Aarhus University.
This study stands as the first investigation into the influence of mental illness on participation in a national screening program that involves submitting stool samples. Mette Kielsholm Thomsen, the postdoc researcher leading the study, expresses deep concern regarding these outcomes.
According to Mette Kielsholm Thomsen, the lead researcher of the study, individuals with severe mental disorders receiving psychiatric treatment or taking antipsychotic medication exhibit significantly lower participation rates in colorectal cancer screening. Surprisingly, even individuals with more common and less severe mental disorders or issues are less likely to participate compared to those without such conditions.
The study utilized data from 2,036,352 Danish individuals aged 50 and above, who were offered colorectal cancer screening. Results indicate that men with severe mental disorders are 13.8 percentage points less likely to participate compared to individuals without mental illness. The gap is even more significant for women, with a difference of 15.4 percentage points. Additionally, individuals with milder mental disorders, such as those requiring antidepressants or psychological treatment but not psychiatric intervention, also demonstrate reduced participation in screening.
Mette Kielsholm Thomsen emphasizes the importance of these findings, stating, "We discovered that individuals with mild mental illnesses are also less inclined to partake in screening programs. This poses a serious problem as they form a relatively large group, increasing the risk of late detection of cancer."
Can have serious consequences
The risk of colorectal cancer and related mortality rises with advancing age. To combat this, the public sector provides a screening program aimed at early detection and prevention. Previous research has demonstrated that individuals with mental disorders face a similar risk of developing cancer as the general population but have a higher mortality rate. Consequently, it is crucial for screening programs to address the obstacles posed by mental challenges for many Danes, emphasizes Mette Kielsholm Thomsen.
Thomsen suggests that the colorectal cancer screening program should be adjusted to accommodate the needs of individuals with mental illness, such as providing necessary support from psychiatrists or general practitioners (GPs) to encourage their participation.
The screening process involves citizens submitting a stool sample for testing. If traces of blood are detected, the individual is invited for a follow-up endoscopy. However, the study reveals that Danes with mental disorders are less inclined to accept the endoscopy, as Thomsen explains:
"We have observed that when they do participate in the screening, they often exhibit signs of blood in their stools more frequently than the general population. However, fewer of them agree to undergo the follow-up endoscopy, resulting in an incomplete screening program."
Thomsen hopes that this study will raise awareness and prompt action to facilitate the participation and completion of cancer screening programs for individuals with mental illness. She expresses her desire for the Danish Health Authority and other relevant stakeholders to take the study seriously and explore ways to minimize barriers hindering individuals with mental illness from accessing preventative healthcare services.
The research results - more information
- Type of study: Register-based study of data from the Danish colorectal cancer screening programme
- Partners: The Danish Cancer Society's National Centre for Cancer Survivorship and General Late Effects: CASTLE, Copenhagen University Hospital - Rigshospitalet, the Department of Clinical Epidemiology at the Department of Clinical Medicine at Aarhus University..
- External funding: The Danish Cancer Society and the Danish Health Foundation.
- Read more in the scientific article: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00179-7/fulltext
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