Journal
CA-A CANCER JOURNAL FOR CLINICIANS
Volume 66, Issue 2, Pages 134-151Publisher
WILEY
DOI: 10.3322/caac.21334
Keywords
epidemiology; health disparities; prevention; screening and early detection
Categories
Funding
- National Institutes of Health [R01MH104574]
- American Cancer Society [123369-CCCDA-12-213-01-CCCDA]
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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. (C) 2015 American Cancer Society.
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