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cervical cancer risk doubles with mental illness and substance abuse

it is estimated that around 380 canadians died from cervical cancer in 2022.

screening means the difference between life and death
researchers advise health-care professionals to "step up preventative measures" in patients struggling with mental health. getty

a new study has found that women with mental illness, neuropsychiatric disability or substance abuse are twice as likely to develop cervical cancer largely because they are less likely to participate in screening programs.

the study, published in the journal the lancet public health, pointed to inequality of care as the main driver of the discrepancy researchers discovered when they took a closer look at the deadly disease, which is the fourth most common cancer among women worldwide. as part of efforts to eradicate cervical cancer, the world health organization has approved a global strategy that requires 70 per cent of women to be screened for the disease at least once before the age of 35 and twice before they turn 45.
“our study identified a high-risk group that needs extra attention if we’re to succeed in eliminating cervical cancer,” said kejia hu, one of the first authors of the study and a postdoctoral researcher at the institute of environmental medicine at karolinska institutet in sweden.  

cervical cancer symptoms

last year, around 1,450 canadian women were expected to be diagnosed with cervical cancer, a form of disease that originates in the cells of the cervix, according to the canadian cancer society. symptoms, which can include vaginal bleeding, unusual discharge and pain during intercourse, are not always present in the early stages and may only appear after tumours have begun to grow into surrounding tissue. it is estimated that around 380 canadians died from the disease in 2022.   

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the current study had access to the health data of over four million women who were born between 1940 and 1995. using this information, researchers were able to calculate the risk of cervical cancer and precancerous lesions among all women in the group and compare the rate of the disease among those who had been diagnosed with mental illness, neuropsychiatric disability or substance abuse to those who had not.
“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,” hu said. “we thus found that they have twice the risk of developing cervical cancer.”  
although the presence of mental illness, neuropsychiatric disability and substance abuse all increased the risk of cervical cancer, researchers found substance abuse held the strongest association. they encouraged women who may be struggling with their mental health to undergo regular screenings.
“it would lower their risk of cancer,” said karin sundström, one of the paper’s authors and a senior researcher in the department of laboratory medicine at karolinska institutet. “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.”  

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the observational study was limited by the fact that researchers did not have full data from its subjects in relation to other risk factors for cervical cancer, including smoking, sexually transmitted diseases and hormonal contraceptives. among the study’s strengths were its size and the length of time subjects were studied.

dave yasvinski is a writer with  healthing.ca

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