title: Cancer screening, prevention, and treatment in people with mental illness.
abstract: People with mental illness die decades earlier in the United States compared with the general population. Most of this disparity is related to preventable and treatable chronic conditions, with many studies finding cancer as the second leading cause of death. Individual lifestyle factors, such as smoking or limited adherence to treatment, are often cited as highly significant issues in shaping risk among persons with mental illness. However, many contextual or systems-level factors exacerbate these individual factors and may fundamentally drive health disparities among people with mental illness. The authors conducted an integrative review to summarize the empirical literature on cancer prevention, screening, and treatment for people with mental illness. Although multiple interventions are being developed and tested to address tobacco dependence and obesity in these populations, the evidence for effectiveness is quite limited, and essentially all prevention interventions focus at the individual level. This review identified only one published article describing evidence-based interventions to promote cancer screening and improve cancer treatment in people with mental illness. On the basis of a literature review and the experience and expertise of the authors, each section in this article concludes with suggestions at the individual, interpersonal, organizational, community, and policy levels that may improve cancer prevention, screening, and treatment in people with mental illness.
authors.affiliation: Associate Professor, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Lara C
authors.initials: LC
authors.lastname: Weinstein
authors.affiliation: Staff Research Associate, Columbia University-School of Social Work, New York, NY.
authors.forename: Ana
authors.initials: A
authors.lastname: Stefancic
authors.affiliation: Clinical Research Coordinator III, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Amy T
authors.initials: AT
authors.lastname: Cunningham
authors.affiliation: Clinical Research Specialist, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Katelyn E
authors.initials: KE
authors.lastname: Hurley
authors.affiliation: Associate Professor, Columbia School of Social Work, New York, NY.
authors.forename: Leopodo J
authors.initials: LJ
authors.lastname: Cabassa
authors.affiliation: Chief Cancer Control Officer, American Cancer Society, Atlanta, GA and Professor, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Wender
mesh_terms: D006801:Humans; D015992:Body Mass Index; D055088:Early Detection of Cancer / Q000379:methods; D008019:Life Style; D055118:Medication Adherence; D001523:Mental Disorders / Q000150:complications; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014481:United States / Q000453:epidemiology
keywords: epidemiology; health disparities; prevention; screening and early detection