Breast Cancer Screening Disparities In Women With Schizophrenia.

(CTN News) – A recent study in JAMA Network Open found that women with schizophrenia have lower rates of completing breast cancer screenings compared to those without schizophrenia.

This is concerning because individuals with schizophrenia often have shorter lifespans, and cancer is a contributing factor. Schizophrenia is one of the top 5 mental health conditions with significant implications in Ontario, Canada.

Patients with schizophrenia also have a higher risk of developing breast cancer, with a 31% increased risk. Early detection through screening is crucial for reducing mortality rates.

To investigate this issue, researchers conducted a retrospective matched case-control study using data from ICES, an organization that evaluates health administrative data in Ontario.

The analysis included all female residents of Ontario over 50 years old with continuous coverage under the Ontario Health Insurance Plan from 2010 to 2019. Schizophrenia status was determined using outpatient and hospitalization data. Exclusion criteria for this analysis included breast cancer diagnosis before age 50,

mastectomy and breast implants before age 50, and high risk of breast cancer. The primary outcome was breast cancer screening within 2 years of turning 50, identified using the Ontario Breast Screening Program.

The study included 11,631 cases (women with schizophrenia) and 115,959 controls (women without schizophrenia). They were matched based on local health integration network, income quintile, rural residence, birth dates within 180 days, and weighted Aggregated Diagnosis Group score.

Among the participants, 8.7% of cases and 8.6% of controls lived in rural communities, and 34.8% of cases and 34.9% of controls were in the lowest income quintile. It was reported that 69.3% of cases and 77.1% of controls had a mammogram within 2 years of turning 50.

Most cases were enrolled in a Family Health Groups (FHG) or Family Health Teams (FHT) primary care physician model, with 30.8% and 24.8% respectively.

Among the cases, 9.5% did not visit a physician during the study period. Patients with schizophrenia in the FHG model were less likely to complete a mammogram compared to those in the FHT model, with an odds ratio of 0.79.

Additionally, 62.5% of participants reported having a mammogram before age 50. This was reported by 55.6% of cases and 63.2% of controls.

The findings of this study revealed that females diagnosed with schizophrenia in Ontario, Canada, are less likely to undergo breast cancer screening.

To enhance the rates of breast cancer screening, the researchers suggested expanding the accessibility of a team-based, capitated primary care payment model.

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