title: Disparities in breast and cervical cancer screening in women with mental illness: a systematic literature review.
abstract: BACKGROUND
  Breast and cervical cancer screening rates have improved substantially in the U.S. during the past decade. Cancer screening and other health outcomes in patients with mental illnesses, such as major depression and schizophrenia, remain suboptimal. Understanding the prevalence and root causes of these disparities is an essential first step toward developing effective interventions. This paper presents a systematic literature review of current evidence on breast and cervical cancer screening disparities in women with mental illness.
  
  
  METHODS
  A systematic PubMed/MEDLINE and PsycINFO search completed in May 2012 retrieved articles pertaining to cancer screening and mentally ill patients using pertinent search terms. Articles that met the inclusion criteria were appraised critically for evidence quality related to screening disparities using defined criteria. Articles that reported cancer screening rates in patients with mental illness were reviewed to determine whether any barriers to screening or factors that promote screening were identified.
  
  
  RESULTS
  Nineteen studies met the inclusion criteria. Many articles contributed to more than one of the identified areas of interest (i.e., screening utilization, barriers to screening, and factors that encourage screening).
  
  
  CONCLUSIONS
  Substantial evidence in the current literature confirms disparities in breast and cervical cancer screening rates among women with mental illness. However, the mentally ill population is more complex and diverse than many studies imply. Using a global functional indicator that measures the overall impact of mental illness may yield a more useful categorization of influences on cancer screening.
authors.affiliation: Division of General Internal Medicine, Virginia Commonwealth University, Richmond, Virginia. Electronic address: aaggarwal@mcvh-vcu.edu.
authors.forename: Arpita
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Ananda
authors.initials: A
authors.lastname: Pandurangi
authors.affiliation: Division of General Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Wally
authors.initials: W
authors.lastname: Smith
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000592:standards; D001523:Mental Disorders / Q000453:epidemiology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*