Women with mental illness have a risk for cervical cancer that’s twice as high as that for others, according to new research.

Swedish researchers noted that women with mental illness, neuropsychiatric disability or substance abuse were also less likely to get screening tests that can detect cervical cancer.

“Our results suggest that women with these diagnoses participate more seldom in screening programs at the same time as they have a higher incidence of lesions in the cervix,” said co-author Kejia Hu, a postdoctoral researcher at the Institute of Environmental Medicine at Karolinska Institute in Solna, Sweden. “We thus found that they have twice the risk of developing cervical cancer.”

The study included more than 4 million women born between 1940 and 1995.

Researchers calculated their risk of cervical cancer and precancerous cervical lesions, as well as women’s participation in screening programs. They compared women diagnosed with a substance use or mental health disorder or disability with women who did not have these diagnoses.

Cancer risk was elevated with all of these diagnoses, researchers found, most of all with substance abuse.

In 2020, the World Health Organization announced a global strategy for eliminating cervical cancer. It aims to screen 70% of women for the disease at least once before age 35 and twice before age 45.

Unequal care is a major obstacle to reaching this goal, the authors said.

“Our study identified a high-risk group that needs extra attention if we’re to succeed in eliminating cervical cancer,” Hu said in an institute news release.

Women with mental illness should be made more aware of the need for regular screening, researchers said.

“It would lower their risk of cancer,” said co-author Karin Sundström, a senior researcher in the Department of Laboratory Medicine at the Karolinska Institute. “Similarly, if health care professionals are more aware of the cancer risk in these patients, they can step up preventative measures and consider how these could be delivered to potentially underserved patients.”

While researchers said the size of the study and its long observation period were strengths, they noted that they lacked full data about other cervical cancer risks, including use of tobacco and hormonal contraceptives and the presence of sexually transmitted diseases.

Study findings were published online March 23 in The Lancet Public Health.

More information

The U.S. National Cancer Institute has more on cervical cancer.

SOURCE: Karolinska Institute, news release, March 23, 2023