Mental illness and participation in colorectal cancer screening: a scoping review

Introduction Compared with the background population, persons with mental illness have increased colorectal cancer (CRC) mortality. Screening has the potential to alleviate the increased cancer mortality due to mental illness, but the extent to which persons with mental illness participate in CRC screening programs is uncertain. This scoping review aims to summarize the literature on CRC screening participation among persons with mental illness. Materials and methods We searched four databases (PubMed, PsychInfo, Embase, and the Cochrane Library) to identify published literature on mental illness and participation in CRC screening programs. We included full-text papers available in English, published before February 2021, and excluded papers on dementia, intellectual disabilities, and developmental disabilities. Results In total, we included 17 studies and categorized the findings according to severity of mental illness. Across varying study designs, the studies found that persons with severe mental illness, e.g. schizophrenia, participate less in CRC screening compared with the background population. The results were ambiguous for common mental illness, such as depression and anxiety. In general, studies were small or lacked comparison groups and the estimates were imprecise. Conclusion This is the first scoping review to evaluate participation in CRC screening programs among persons with mental illness. Overall, the existing literature lacks high quality evidence from large population-based studies and comparison groups based on organized screening programs.

Automated summary

This scoping review evaluates the participation of persons with mental illness in CRC screening programs. The findings suggest that individuals with severe mental illness, such as schizophrenia, participate less in CRC screening compared to the general population. Results for common mental illnesses, such as depression and anxiety, were inconclusive. Overall, the existing literature lacks high quality evidence from large population-based studies and comparison groups based on organized screening programs.