Tohoku J. Exp. Med., 2018 March, 244(3)

Low Cancer Screening Rates among Japanese People with Schizophrenia: A Cross-Sectional Study

MASATOSHI INAGAKI,¹ MASAKI FUJIWARA,² NAOKI NAKAYA,³ MAIKO FUJIMORI,^4,5 YUJI HIGUCHI,⁶ CHINATSU HAYASHIBARA,² RYUHEI SO,⁷ KYOKO KAKEDA,⁸ MASAFUMI KODAMA,⁷ YOSUKE UCHITOMI^9,10,11 and NORIHITO YAMADA²

¹Department of Neuropsychiatry, Okayama University Hospital, Okayama, Okayama, Japan
²Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Okayama, Japan
³Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
⁴Division of Cohort Consortium Research, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
⁵Division of Health Care Research, QOL Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
⁶Department of Psychiatry, Taiyo Hills Hospital, Takahashi, Okayama, Japan
⁷Okayama Psychiatric Medical Center, Okayama, Okayama, Japan
⁸Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
⁹Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
¹⁰Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
¹¹Center for Public Health Sciences, National Cancer Center, Tokyo, Japan

Health care disparities among people with schizophrenia is a global concern. Our previous study revealed cancer screening rates in Japanese people with schizophrenia lower than rates of approximately 40% of the general population. However, that study was based on self-reports, which can be inaccurate, and rates did not differentiate the types of cancer screening provider (i.e., municipal screening, collective opportunistic screening, and individual opportunistic screening). This study aimed to investigate records-based cancer screening rates, focusing on participation rates of people with schizophrenia who are subject to municipal cancer screening programs. We conducted a cross-sectional study at a psychiatric hospital outpatient clinic from September to November 2016. We randomly extracted 420 potential participants from among 680 eligible patients and asked them to participate. We then selected subgroups of participants living in Okayama city who were enrolled in the National Health Insurance or Public Assistance systems and were subject to colorectal, gastric, lung, breast, or cervical cancer screening provided by Okayama city (n = 97, 96, 97, 42, and 64, respectively). Participation in cancer screenings was assessed based on local government records. Municipal cancer screening rates were as follows: 13.4% (95% confidence interval: 6.6%-20.2%) for colorectal, 7.3% (2.1%-12.5%) for gastric, 16.5% (9.1%-23.9%) for lung, 21.4% (9.0%-33.8%) for breast, and 14.1% (5.6%-22.6%) for cervical cancers. The findings demonstrated extremely low cancer screening rates among people with schizophrenia subject to municipal cancer screenings in Japan. A strategy to promote municipal cancer screening for people with schizophrenia is needed.

keywords —— cancer screening, healthcare disparities, mental disorder, preventive health services, schizophrenia

© 2018 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2018, 244, 209-218

Correspondence: Masatoshi Inagaki, Department of Neuropsychiatry, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama 700-8558, Japan.

e-mail: masatoshiinagaki@okayama-u.ac.jp