Mental Illness May Compromise Cancer Care

Article excerpt

BOSTON -- Older adults with mental illness are less likely to undergo chemotherapy after a cancer diagnosis than those without mental illness, a study has shown. The findings are consistent with those from previous studies suggesting disparities in the care of chronic conditions among mentally ill older adults, Dr. Simha E. Ravven reported at the meeting.

"Even though adults with mental illness are often well connected to primary care, our findings suggest that they may not be receiving the same kind of cancer treatment and that they may need more support and counseling to get the same care," said Dr. Ravven, a fellow at Harvard Medical School, Boston.

To determine whether cancer screening and treatment vary for people with prior mental illness, and if mortality after a cancer diagnosis differs in this population, Dr. Ravven and her colleagues reviewed records for the 19,045 participants of the year 2000 wave of the National Institute on Aging's nationally representative, longitudinal Health and Retirement Study (HRS). The study, conducted by the University of Michigan, Ann Arbor, surveyed adults born in 1947 or earlier to assess mental health, financial status, family support, and retirement planning among aging Americans, she said.

Of the full study cohort, about 14% had a history of mental illness, according to Dr. Ravven. While both men and women with a history of mental illness were as likely to receive clinical cancer screening, including a breast exam, a Pap test, mammography, and a prostate exam within 2 years prior to the survey as part of the general population, individuals with mental illness who had a recent cancer diagnosis were significantly less likely to receive chemotherapy, with an odds ratio of 0.33, she said. No significant differences wee found in receipt of radiation therapy, surgery, or biopsy, she reported.

When assessed by gender, the odds ratio for receiving chemotherapy among women with a history of mental illness was especially low relative to women without mental illness, with an odds ratio of 0. …