Psychiatric morbidity and non-participation in breast cancer screening
Psychiatric morbidity and non-participation in breast cancer screening
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DOI：
10.1016/j.breast.2015.10.002
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发表时间：
2016-02-01
期刊：
影响因子：
3.9
通讯作者：
Vedsted, Peter
中科院分区：
文献类型：
--
作者：
Jensen, Line Flytkjaer;Pedersen, Anette Fischer;Vedsted, Peter
背景：有组织的乳腺癌筛查是目前早期乳腺癌检测的最佳策略之一。然而，早期发现已被证明对患有精神疾病的妇女具有挑战性。本研究旨在调查精神病发病率和不参加乳腺癌筛查。方法：我们进行了一项观察性队列研究，包括妇女邀请到第一轮有组织的筛选在中央丹麦地区。从丹麦登记处获得关于精神病诊断、精神活性处方药和私人精神科医生咨询的数据，并在筛选日期前长达10年进行评估。结果：该队列包括144，264名妇女，其中33.0%登记有精神疾病指征。我们发现，在患有精神病诊断的女性中，特别是患有精神分裂症和药物滥用的女性，不参与倾向升高。此外，较轻的精神病发病率与较高的不参与可能性相关，因为兑换过精神活性处方药或至少与私人精神科医生进行过一次咨询的女性更有可能不参与。最后，我们发现，慢性精神疾病的发病率与不参与和妇女有精神疾病定义为“持久性”有较高的可能性不参与比妇女最近活跃的发病率或非活跃的精神疾病。结论：这项研究表明，精神病发病率和不参与乳腺癌筛查的可能性增加之间有很强的关联，在医疗保健系统与普遍和税收资助的卫生服务。这方面的知识可能会告知干预措施，针对妇女的精神疾病，因为他们有较差的乳腺癌预后。(C)2015爱思唯尔有限公司版权所有。
Background: Organised breast cancer screening is currently one of the best strategies for early-stage breast cancer detection. However, early detection has proven challenging for women with psychiatric disease. This study aims to investigate psychiatric morbidity and non-participation in breast cancer screening. Methods: We conducted an observational cohort study including women invited to the first organised screening round in the Central Denmark Region. Data on psychiatric diagnosis, psychoactive prescription medicine and consultation with private psychiatrists were obtained from Danish registries and assessed for a period of up to 10 years before the screening date. Results: The cohort comprised 144,264 women whereof 33.0% were registered with an indication of psychiatric morbidity. We found elevated non-participation propensity among women with a psychiatric diagnosis especially for women with schizophrenia and substance abuse. Also milder psychiatric morbidity was associated with higher non-participation likelihood as women who had redeemed psychoactive prescription medicine or have had minimum one consultation with a private psychiatrist were more likely not to participate. Finally, we found that the chronicity of psychiatric morbidity was associated with non-participation and that woman who had a psychiatric morbidity defined as 'persistent' had higher likelihood of non-participation than women with recently active morbidity or inactive psychiatric morbidity. Conclusion: This study showed a strong association between psychiatric morbidity and an increased likelihood of non-participation in breast cancer screening in a health care system with universal and tax-funded health services. This knowledge may inform interventions targeting women with psychiatric morbidity as they have poorer breast cancer prognosis. (C) 2015 Elsevier Ltd. All rights reserved.