Gynecological Health Concerns in Women with Schizophrenia and Related Disorders: A Narrative Review of Recent Studies

Sex and age are important factors influencing physical and mental health in schizophrenia. Our goal was to review the recent literature for associations between gynecological conditions and psychotic illness and to propose integrated strategies for their management in order to improve overall health outcomes in women. We addressed the following questions: What are the prevalence and risk factors of gynecological disorders in women with schizophrenia or delusional disorder (DD)? What are the rates of uptake of gynecological cancer screening and mortality in this population? What role does menopause play? We found an increased incidence of breast cancer in women with schizophrenia. Other gynecological comorbidities were less frequent, but the field has been understudied. Low rates of breast and cervical cancer screening characterize women with schizophrenia. Menopause, because of endocrine changes, aging effects, and resultant comorbidity is associated with high rates of aggressive breast cancer in this population. Uterine and ovarian cancers have been less investigated. Psychosocial determinants of health play an important role in cancer survival. The findings lead to the recommendation that primary care, psychiatry, gynecology, oncology, and endocrinology collaborate in early case finding, in research into etiological links, and in improvement of prevention and treatment.

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Functional health literacy in Spanish-speaking Latinas seeking breast cancer screening through the National Breast and Cervical Cancer Screening Program

International Journal of Women s Health ◽

10.2147/ijwh.s4957 ◽

2009 ◽

pp. 21 ◽

Cited By ~ 1

Author(s):

Samantha Garbers

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Screening Program ◽

Functional Health ◽

Functional Health Literacy ◽

Spanish Speaking ◽

Breast And Cervical Cancer ◽

National Breast ◽

Cancer Screening Program ◽

Cervical Cancer Screening Program

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Patterns and Trends of Cancer Screening in Canada: Results From a Contemporary National Survey

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2020.7613 ◽

2021 ◽

Vol 19 (1) ◽

pp. 68-76

Author(s):

Omar Abdel-Rahman

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Pap Test ◽

Complete Information ◽

Screening Tests ◽

Visible Minority ◽

Crc Screening ◽

Breast And Cervical Cancer

Background: The aim of this study was to assess the patterns and trends of colorectal, breast, and cervical cancer screening within a contemporary cohort of Canadian adults. Methods: Canadian Community Health Survey datasets (2007–2016) were accessed and 3 cohorts were defined: (1) a colorectal cancer (CRC) screening cohort, defined as men and women aged 50 to 74 years with complete information about CRC screening tests and their timing; (2) a breast cancer screening cohort, defined as women aged 40 to 74 years with complete information about mammography and its timing; and (3) a cervical cancer screening cohort, defined as women aged 25 to 69 years with complete information about the Papanicolaou (Pap) test and its timing. Multivariable logistic regression analysis was then performed to evaluate factors associated with not having timely screening tests at the time of survey completion. Results: A total of 99,820 participants were considered eligible for the CRC screening cohort, 59,724 for the breast cancer screening cohort, and 46,767 for the cervical cancer screening cohort. Among eligible participants, 43% did not have timely recommended screening tests for CRC, 35% did not have timely mammography (this number decreased to 26% when limiting the eligible group to ages 50–74 years), and 25% did not have a timely Pap test. Lower income was associated with not having a timely recommended screening tests for all 3 cohorts (odds ratios [95% CI]: 1.86 [1.76–1.97], 1.89 [1.76–2.04], and 1.96 [1.79–2.14], respectively). Likewise, persons self-identifying as a visible minority were less likely to have timely recommended screening tests in all 3 cohorts (odds ratios for White race vs visible minority [95% CI]: 0.87 [0.83–0.92], 0.85 [0.80–0.91], and 0.66 [0.61–0.70], respectively). Conclusions: More than one-third of eligible individuals are missing timely screening tests for CRC. Moreover, at least one-quarter of eligible women are missing their recommended breast and cervical cancer screening tests. More efforts from federal and provincial health authorities are needed to deal with socioeconomic disparities in access to cancer screening.

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Depressive symptoms, neuroticism and participation in breast and cervical cancer screening in the UK

European Journal of Public Health ◽

10.1093/eurpub/ckz185.032 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C L Niedzwiedz ◽

K A Robb ◽

S V Katikireddi ◽

J P Pell ◽

D J Smith

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Depressive Symptoms ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Breast And Cervical Cancer ◽

Screening Participation ◽

The Uk ◽

Prospective Analyses

Abstract Background Globally, more than 2 million women are diagnosed with breast or cervical cancer every year. Depressive symptoms and personality traits have been implicated in cancer-related mortality, but the potential mechanisms through which these associations may operate are not well understood. We aimed to assess how depressive symptoms and neuroticism are associated with participation in breast and cervical cancer screening. Methods 273 402 women in the UK Biobank cohort who were eligible for breast cancer screening (aged 50-70 years) and/or cervical cancer screening (<65 years) at baseline recruitment (2006-10) and those with follow-up data (2014-March 19) were identified. Depressive symptoms (4 items from Patient Heath Questionnaire) and neuroticism (12 items from Eysenck Personality Inventory Neuroticism Scale) were self-reported at baseline. The primary outcomes were reporting being up to date with breast and cervical cancer screening. For prospective analyses, patterns of screening participation from baseline to follow-up were derived. Logistic regression was used to analyse associations, adjusted for potential confounders. Results More severe depressive symptoms (range 0-12) were associated with reduced screening for breast (OR = 0.960, 95% CI: 0.950,0.970) and cervical cancer (OR = 0.958, 95% CI: 0.950,0.966). Prospective analyses revealed higher baseline depressive symptoms were related to decreased cervical cancer screening at follow-up (OR = 0.955, 95% CI: 0.913,0.999; equivalent to a difference of 4.08% between the highest and lowest depressive symptom score), but not with breast cancer screening. Results for overall neuroticism were inconclusive, but individual neuroticism items including anxiety and nervousness were related to increased screening participation. Conclusions More severe depressive symptoms may act as a barrier for cancer screening participation and could be an indication for more proactive strategies to improve uptake. Key messages Women with more severe depressive symptoms are less likely to be up to date with their breast and cervical cancer screening, which may exacerbate existing health inequalities. Interventions to increase screening participation among women with poor mental health may be merited.

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Raising Awareness About Women’s Cancer and Increasing Local Engagement With Healthcare Services in Haiti

Journal of Global Oncology ◽

10.1200/jgo.2016.004424 ◽

2016 ◽

Vol 2 (3_suppl) ◽

pp. 26s-26s

Author(s):

Grace Tillyard ◽

Jean Renald Cornely ◽

Estefania Santamaria ◽

Gerty Surena ◽

Mita Alcindor Casimir ◽

...

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Cancer Screening ◽

Healthcare Services ◽

Advisory Board ◽

Community Advisory Board ◽

Cancer Awareness ◽

Human Centered Design ◽

Low Resource ◽

Breast And Cervical Cancer

Abstract 37 Background: Project Medishare launched a breast cancer program in Port-au-Prince in 2013. In 2015, the program was expanded as part of a national breast cancer treatment program. Project Medishare is currently implementing a women’s cancer awareness campaign funded by the Union for International Cancer Control (UICC). The program will explore and address the complex social and cultural narratives around women’s cancer in Haiti. This will be accomplished using human-centered design to build a communications tool-kit for community health workers. The program was conceived with local partners and the Haitian government. Both parties sought to increase breast and cervical cancer screening, as well as reduce the number of late-stage presentations. Methods: Project Medishare has adopted methods from Community-Based-Participatory-Research (CBPR) in order to identify and foster a community of actors involved in women’s health, and cancer screening and treatment in Haiti. Since September 2015, a group of 8 distinct Haitian organizations, including the government, make up a Community Advisory Board that conducts research and explores different programmatic approaches in the fight against breast and cervical cancer in Haiti. Results: Through creation of the advisory board and equitable partnerships with local organizations, the group has had success in fostering engagement and ownership over challenges presented by screening and treating cancer in a low-resource setting. The group designed and implemented a nationwide survey to document reasons why communities and individuals in Haiti do not engage with healthcare services provided until cancer is at an advanced stage, despite a basic awareness of the disease and visible symptoms. Once collected, the group will work towards a collective interpretation of the data and will determine how it should be used. Conclusions: Like academic institutions, CBPR methods can be invaluable to organizations researching barriers to care and addressing health inequalities in low-resource settings. Creating a community advisory board encourages local ownership of research outcomes and projects. Future endeavors will consist of sharing the resources created by CBPR and human-centered design, to build a network of partners and implement a national cancer awareness program to parallel our national comprehensive cancer program efforts. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

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Increasing Breast and Cervical Cancer Screening Uptake in Women of Child-Bearing Age in Niger State, Nigeria

Journal of Global Oncology ◽

10.1200/jgo.18.85900 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 213s-213s ◽

Cited By ~ 1

Author(s):

H.T. Kolo

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Screening Program ◽

Screening Uptake ◽

Breast And Cervical Cancer ◽

Cancer Screening Program ◽

Cervical Cancer Screening Program ◽

Screening Services

Background: Prevalence of breast and cervical cancer are on the increase in the developing countries despite the knowledge of how these diseases can be prevented through screening. Reproductive rights, Advocacy, Safe space and Empowerment Foundation (RAISE) initiated breast and cervical cancer screening program in Niger State as part of its reproductive health services. The program is hereby evaluated with the aim of improving its performance toward reducing burden of these diseases in Niger State. Aim: To evaluate the breast and cervical cancer screening program, to report the experience from the program, and to recommend necessary changes and scaling up of best practices. Methods: Audit of the breast and cervical cancer screening program was conducted. The basic components of cervical cancer screening programs; screening uptake, screening services, treatment of screen positives, follow-up and referrals were audited against previously set standards for the program. The difference in screening uptake for breast and cervical cancer was evaluated for better understanding of factors determining screening uptake in Niger state. Results: Between 18 July 2016 and 30 April 2018, 2035 women between the age of 15-75 years were screened for breast cancer and 1258 women between the age of 20-55 years were screened for cervical cancer, representing about 38% higher uptake of breast cancer screening compared with cervical cancer. The parity range of these women is 0-20. The mean age and parity for women screened during the audit period were; 35 years and 8 for breast cancer, while 29 years and 7 for cervical cancer. Fifty-two (2.56%) of the 2035 women screened for breast cancer had a palpable lump in either 1 or both breasts, while 4 (0.3%) of the 1258 women screened for cervical cancer had a positive result (aceto-white lesions) treated with cryotherapy. The women have low socioeconomic status with predominantly farmers, petty traders and housewives earning less than $2 per day. Most of the women are illiterate with little or no form of education. Other possible barriers for low uptake of breast and cervical cancer screening is lack of transportation, religious and cultural beliefs, shyness and lack of sensitization. Conclusion: Screening uptake is still very poor despite massive awareness campaign. The current awareness creation strategy has not been able to create needed demand for the available screening services. A total overhaul of awareness creation strategies is therefore advocated.

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The Role of Medical Tourism in Cancer Screening among Korean Immigrant Women

Health Behavior and Policy Review ◽

10.14485/hbpr.6.5.10 ◽

2019 ◽

Vol 6 (5) ◽

pp. 522-533 ◽

Cited By ~ 1

Author(s):

Sou Hyun Jang ◽

Eun Jeong Lee ◽

Jae A. Lim ◽

Thuy Vu ◽

Victoria M. Taylor ◽

...

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Medical Tourism ◽

Strong Predictor ◽

Cost Of Care ◽

Korean Immigrant ◽

Cross Sectional ◽

Breast And Cervical Cancer

Objective: Korean immigrant (KI) women have lower breast and cervical cancer screening rates than other Asian women subgroups. Medical tourism has emerged as a strong predictor for some types of cancer screening but has not been examined thoroughly with breast and cervical cancer screening. This study examines the association between medical tourism and breast and cervical cancer screening among KI women. Methods: Data came from a cross-sectional study examining health behaviors of KIs in the Seattle, Washington metropolitan area. Women ages 40-74 years were included in the analysis (N = 102). Outcomes were up-to-date with breast cancer screening and up-to-date with cervical cancer screening. Predictors included socio-demographics, health factors, acculturation, worry about cost of care, and medical tourism. Data analysis included logistic regression. Results: In multivariate modeling, medical tourism was the only predictor associated with both breast and cervical cancer screening. Women who engaged in medical tourism had greater odds of being up-to-date with breast cancer and cervical cancer screening respectively, compared to those not engaged in medical tourism. Conclusion: Many KI women are participating in medical tourism for cancer care. Our findings have broad implications for KI women in the US and their US providers.

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Factors associated with and socioeconomic inequalities in breast and cervical cancer screening among women aged 15–64 years in Botswana

PLoS ONE ◽

10.1371/journal.pone.0255581 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255581

Author(s):

Mpho Keetile ◽

Kagiso Ndlovu ◽

Gobopamang Letamo ◽

Mpho Disang ◽

Sanni Yaya ◽

...

Keyword(s):

Breast Cancer ◽

Cervical Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Cervical Cancer Screening ◽

Rural Areas ◽

Decomposition Analysis ◽

Socioeconomic Inequalities ◽

Factors Associated ◽

Breast And Cervical Cancer

Background The most commonly diagnosed cancers among women are breast and cervical cancers, with cervical cancer being a relatively bigger problem in low and middle income countries (LMICs) than breast cancer. Methods The main aim of this study was to asses factors associated with and socioeconomic inequalities in breast and cervical cancer screening among women aged 15–64 years in Botswana. This study is part of the broad study on Chronic Non-Communicable Diseases in Botswana conducted (NCD survey) in 2016. The NCD survey was conducted across 3 cities and towns, 15 urban villages and 15 rural areas of Botswana. The survey collected information on several NCDs and risk factors including cervical and breast cancer screening. The survey adopted a multistage sampling design and a sample of 1178 participants (males and females) aged 15 years and above was selected in both urban and rural areas of Botswana. For this study, a sub-sample of 813 women aged 15–64 years was selected and included in the analysis. The inequality analysis was conducted using decomposition analysis using ADePT software version 6. Logistic regression models were used to show the association between socioeconomic variables and cervical and breast cancer screening using SPSS version 25. All comparisons were considered statistically significant at 5%. Results Overall, 6% and 62% of women reported that they were screened for breast and cervical cancer, respectively. Women in the poorest (AOR = 0.16, 95% CI = 0.06–0.45) and poorer (AOR = 0.37, 95% CI = 0.14–0.96) wealth quintiles were less likely to report cervical cancer screening compared to women in the richest wealth quintile. Similarly, for breast cancer, the odds of screening were found to be low among women in the poorest (AOR = 0.39, 95% CI = 0.06–0.68) and the poorer (AOR = 0.45, 95% CI = 0.13–0.81)) wealth quintiles. Concentration indices (CI) showed that cervical (CI = 0.2443) and breast cancer (CI = 0.3975) screening were more concentrated among women with high SES than women with low SES. Wealth status was observed to be the leading contributor to socioeconomic inequality observed for both cervical and breast cancer screening. Conclusions Findings in this study indicate the need for concerted efforts to address the health care needs of the poor in order to reduce cervical and breast cancer screening inequalities.

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Breast and cervical cancer screening disparities among transgender patients.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.7024 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 7024-7024

Author(s):

Oluwadamilola Temilade Oladeru ◽

Sung Jun Ma ◽

Joseph Miccio ◽

Katy Wang ◽

Kristopher Attwood ◽

...

Keyword(s):

Breast Cancer ◽

Primary Care ◽

Cervical Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Cervical Cancer Screening ◽

Care Physician ◽

Weighted Estimate ◽

Cross Sectional ◽

Breast And Cervical Cancer

7024 Background: Over a million Americans identify themselves as transgender and this population is growing. Transgender status was a pre-existing condition prior to the Affordable Care Act (ACA), and transgender individuals faced unique disparities in gender-specific cancer screening in part due to discrimination in health insurance coverage. Modern literature for transgender adults’ adherence to cancer screening is limited. To fill this knowledge gap, we conducted a cross sectional study to investigate transgender individuals’ self-reported adherence to cancer screening and access to primary care compared to cisgender individuals. Methods: The Behavioral Risk Factor Surveillance System database was queried for transgender (either male-to-female [MTF] or female-to-male [FTM]) and cisgender adults from 2014-2016 and 2018. Primary endpoints were adherence to breast and cervical cancer screening guidelines and access to primary health care. Those with prior hysterectomy, breast and cervical cancer were excluded. Multivariable logistic regression was performed to evaluate the association of transgender status with cancer screening and healthcare access, after adjusting for demographic characteristics and survey weights. Results: A total of 219,665 and 206,446 participants were eligible for breast and cervical cancer screening, respectively. Of those, 614 (0.28%) and 587 (0.29%) transgender participants were eligible for each cancer screening type, respectively, representing a weighted estimate of nearly 200,000 transgender participants total. When compared to cisgender counterparts, transgender participants were less likely to adhere to breast cancer screening (FTM: OR 0.47, p < 0.001; MTF: OR 0.04, p < 0.001) and to have received any breast cancer screening (FTM: OR 0.32, p < 0.001; MTF: OR 0.02, p < 0.001). Similarly, FTM participants were less likely to adhere to cervical cancer screening (OR 0.42, p < 0.001) and to have received any cervical cancer screening (OR 0.26, p < 0.001). In addition, transgender participants were more likely to have no primary care physician (FTM: OR 0.79, p < 0.001; MTF: OR 0.58, p < 0.001) and to be unable to see a physician when needed within the past year due to medical cost (FTM: OR 1.44, p < 0.001; MTF: OR 1.36, p < 0.001). Conclusions: Despite the implementation of the ACA, limited primary care access and poor adherence to breast and cervical cancer screening are evident for transgender populations. Further research efforts to improve the utilization of preventive cancer services are needed for this underserved population.

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