Breast screening participation and degree of spread of invasive breast cancer at diagnosis in mental health service users, a population linkage study.

Sara, G; Lambeth, C; Burgess, P; Curtis, J; Walton, R; Currow, D

Breast screening participation and degree of spread of invasive breast cancer at diagnosis in mental health service users, a population linkage study.

Sara, G Lambeth, C Burgess, P Curtis, J Walton, R Currow, D

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Cancer, 2023
Issue Date:: 2023-08-26

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Field	Value	Language
dc.contributor.author	Sara, G
dc.contributor.author	Lambeth, C
dc.contributor.author	Burgess, P
dc.contributor.author	Curtis, J
dc.contributor.author	Walton, R
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250
dc.date.accessioned	2023-11-09T23:48:59Z
dc.date.available	2023-07-24
dc.date.available	2023-11-09T23:48:59Z
dc.date.issued	2023-08-26
dc.identifier.citation	Cancer, 2023
dc.identifier.issn	0008-543X
dc.identifier.issn	1097-0142
dc.identifier.uri	http://hdl.handle.net/10453/173293
dc.description.abstract	BACKGROUND: Women living with mental health conditions may not have shared in improvements in breast cancer screening and care. No studies have directly examined the link between reduced screening participation and breast cancer spread in women using mental health (MH) services. METHODS: Population-wide linkage of a population cancer register, BreastScreen register, and mental health service data set in women aged 50 to 74 years in New South Wales, Australia, from 2008 to 2017. Incident invasive breast cancers were identified. Predictors of degree of spread (local, regional, metastatic) at diagnosis were examined using partial proportional odds regression, adjusting for age, socioeconomic status, rurality, and patterns of screening participation. RESULTS: A total of 29 966 incident cancers were identified and included 686 (2.4%) in women with MH service before cancer diagnoses. More than half of MH service users had regional or metastatic spread at diagnosis (adjusted odds ratio, 1.63; 95% CI, 1.41-1.89). MH service users had lower screening participation; however, advanced cancer was more common even when adjusting for screening status (adjusted odds ratio, 1.53; 95% CI, 1.32-1.77). Advanced cancer was more common in women with severe or persistent MH conditions. CONCLUSIONS: Low screening participation rates explain only small part of the risk of more advanced breast cancer in women who use MH services. More study is needed to understand possible mechanisms contributing to more advanced breast cancer in women living with MH conditions. Health systems need strategies to ensure that women living with MH conditions enjoy population gains in breast cancer outcomes.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	Cancer
dc.relation.isbasedon	10.1002/cncr.35002
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1112 Oncology and Carcinogenesis, 1117 Public Health and Health Services
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.classification	3211 Oncology and carcinogenesis
dc.subject.classification	4206 Public health
dc.title	Breast screening participation and degree of spread of invasive breast cancer at diagnosis in mental health service users, a population linkage study.
dc.type	Journal Article
utslib.location.activity	United States
utslib.for	1112 Oncology and Carcinogenesis
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.date.updated	2023-11-09T23:48:57Z
pubs.publication-status	Published online

Abstract:

BACKGROUND: Women living with mental health conditions may not have shared in improvements in breast cancer screening and care. No studies have directly examined the link between reduced screening participation and breast cancer spread in women using mental health (MH) services. METHODS: Population-wide linkage of a population cancer register, BreastScreen register, and mental health service data set in women aged 50 to 74 years in New South Wales, Australia, from 2008 to 2017. Incident invasive breast cancers were identified. Predictors of degree of spread (local, regional, metastatic) at diagnosis were examined using partial proportional odds regression, adjusting for age, socioeconomic status, rurality, and patterns of screening participation. RESULTS: A total of 29 966 incident cancers were identified and included 686 (2.4%) in women with MH service before cancer diagnoses. More than half of MH service users had regional or metastatic spread at diagnosis (adjusted odds ratio, 1.63; 95% CI, 1.41-1.89). MH service users had lower screening participation; however, advanced cancer was more common even when adjusting for screening status (adjusted odds ratio, 1.53; 95% CI, 1.32-1.77). Advanced cancer was more common in women with severe or persistent MH conditions. CONCLUSIONS: Low screening participation rates explain only small part of the risk of more advanced breast cancer in women who use MH services. More study is needed to understand possible mechanisms contributing to more advanced breast cancer in women living with MH conditions. Health systems need strategies to ensure that women living with MH conditions enjoy population gains in breast cancer outcomes.

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http://hdl.handle.net/10453/173293