Mental illness creates barriers to healthcare, and in this study, patients with a pre-existing psychiatric disorder were found to be less likely to be diagnosed with breast cancer at an early stage.
Mental illness increases mortality rates in individuals with breast cancer. Early detection is one of the greatest determinants of survival rate, but women with mental illness tend to delay diagnosis, making treatment more complex and often less effective. Women over age 65 diagnosed in stage IV have only a 24% five-year survival rate, compared to almost 100% if diagnosed in stage 0 or I.
To catch breast cancer early, guidelines suggest that women receive regular screenings and monitor new lumps, swelling, or pain in breast tissue. However, psychiatric symptoms might prevent women from engaging in these regular health checks. Additionally, mental illnesses often co-occur with systemic barriers like healthcare stigma, poor insurance, or comorbid disease management, making it easier to overlook the symptoms of breast cancer.
A recent meta-analysis utilized the national Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database to explore whether pre-existing mental illness, age, and race correlated with breast cancer stage at diagnosis.
Patients diagnosed with a serious mental illness prior to their cancer diagnosis were 30% more likely to be diagnosed at Stage II or III. Black, Hispanic, and Asian and Pacific Islander women were diagnosed at later stages than White women. In line with previous research, older women were typically diagnosed with later-stage cancers.
These findings demonstrate the urgency with which preventative care must become more accessible, especially in patients with mental illness. Patients would benefit from social support around regular mammography and more crosstalk between somatic and psychiatric care, as mental health providers may be the primary inlet to healthcare for some patients.
Bhattacharya, M., Parsons, H., Call, K., Blaes, A., & McAlpine, D. (2023). Impact of a pre-existing diagnosis of mental illness on stage of breast cancer diagnosis among older women. Breast Cancer Res Treat, 197(1), 201-210. https://doi.org/10.1007/s10549-022-06793-z