Objective
This presentation aims to review the disparities and to examine the multi-level barriers and facilitators.
Content
We first summarize the evidence of lower cancer screening rates across various cancer types (e.g., breast, cervical) in patients with SMI, drawing on a systematic review and recent studies. We then discuss the multi-level barriers that contribute to these disparities, categorized into patient-level (e.g., psychiatric symptoms, cognitive impairments), provider-level (e.g., communication gaps, lack of knowledge), and system-level factors (e.g., lack of service integration). Next, we detail our research in Japan, where we developed an encouragement intervention for colorectal cancer screenings and evaluated its efficacy. Our patient-level intervention in psychiatric outpatient settings, incorporating patient education and navigation, demonstrated a significant increase in colorectal cancer screening uptake in patients with schizophrenia. We also developed provider-level implementation strategies to make this intervention available in routine psychiatric outpatient settings. To evaluate the effect of implementing the intervention, our work further includes the development of methods to monitor screening disparities at a community level.
Conclusion
Although effective patient-level interventions and provider-level implementation strategies have been identified, the challenge of establishing systemic change and ensuring sustainability remains. Addressing cancer screening disparities in patients with SMI requires a global, collaborative approach. Sharing context-specific interventions and implementation strategies internationally will generate the evidence and momentum needed to embed change within systems and promote health equity.