Tuesday, October 11, 2022

Patients With Mental Illness Found Less Likely to Undergo Recommended Colorectal Screening

People with mental illness may be less likely to participate in recommended colorectal cancer screenings than people without mental illness, suggests an article in the American Journal of Preventive Medicine.

“Colorectal cancer is one of the most frequent causes of cancer-related deaths in high-income countries,” wrote Benedicte Kirkøen, Ph.D., of the Cancer Registry of Norway, Oslo, Norway. The U.S. Preventive Services Task Force as well as the European Union recommend that adults receive regular screenings for colorectal cancer.

To examine the impact of different types and doses of psychotropic medications on participation in colorectal screenings, Kirkøen and colleagues analyzed data collected from nearly 117,000 adults aged 50 to 74 years who were participants in a large clinical trial in Norway. The data included 46,919 adults who were invited to receive a sigmoidoscopy screening, and 70,019 who were invited to receive fecal immunochemical testing. Data on psychotropic medication prescriptions from four years before the date of the screening invitation were obtained from the Norwegian Prescription Database. Kirkøen and colleagues specifically focused on participants who received at least two prescriptions of at least one of the following classes of psychotropic medications in the 12 months before the screening invitation: antipsychotics, anxiolytics, hypnotics and sedatives, and antidepressants.

Of the 116,938 participants invited to a colorectal screening, 55.7% received either a sigmoidoscopy screening or fecal immunochemical testing, the researchers found. In the 12 months preceding the screening invitation, 19.2% of the invitees (24.8% of women, 13.4% of men) were prescribed at least one class of psychotropic medication; 10.1% used hypnotics or sedatives, 8.5% used antidepressants, 6.3% used anxiolytics, and 2.6% used antipsychotics.

“The use of psychotropic medications, in particular anxiolytics and antipsychotics, was inversely associated with screening participation, independent of the screening method,” Kirkøen and colleagues wrote. The more psychotropic medications a participant was taking, the odds of participation in colorectal screening decreased, they noted.

“Together, these findings show significant disparities in [colorectal screening] participation for people with mental illness, differing according to type and dose of psychotropic medication,” Kirkøen and colleagues concluded. “Targeted interventions are warranted to ensure that people with mental illness are supported to access the benefits of colorectal cancer screening.”

For related information, see the Psychiatric Services article “Impact of Psychiatric Diagnoses and Treatment on Postoperative Outcomes Among Patients Undergoing Surgery for Colorectal Cancer.”

(Image: iStock/FatCamera)

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