Trends in uptake of cancer screening among people with severe mental illness before and after the COVID-19 pandemic in Japan: A repeated cross-sectional study.

Aim: The aim of this study was to investigate trends in cancer screening participation among people with severe mental illness (PSMI) from periods before and after the COVID-19 pandemic.
Methods: In this repeated cross-sectional study, we used anonymized datasets on municipal cancer screening participation among PSMI in Okayama City. The data covered fiscal year (FY) 2018 to FY2022; we used the municipal cancer screening database and Medical Payment for Services and Supports for Persons with Disabilities. PSMI were defined as those with schizophrenia or related psychotic disorders (F20-29) or bipolar disorder (F30 or F31), identified using International Classification of Diseases , Tenth Revision, codes. The analysis included men and women aged 40-69 years for colorectal and lung cancer screening; men and women aged 50-69 years for gastric cancer screening; women aged 40-69 years for breast cancer screening; and women aged 20-69 years for cervical cancer screening. Municipal cancer screening rates among PSMI were calculated for each FY.
Results: For all cancer types, cancer screening rates for PSMI in FY2020 (colorectal: 9.0%; lung: 11.6%; gastric: 4.9%; breast: 6.2%; and cervical: 6.1%) were lower than the rates in FY2019 (11.5%, 14.0%, 6.5%, 9.3%, and 8.3%, respectively). In FY2022, the rates (9.9%, 12.9%; 5.3%; 8.0%, and 6.9%, respectively) recovered, but remained low.
Conclusion: This study showed that cancer screening rates among PSMI were very low, both before and after the COVID-19 pandemic. Efforts to encourage participation in cancer screening in this population are urgently needed.
Competing Interests: Y. Yamada has received honoraria from Meiji, Sumitomo Pharma, Takeda, and Lundbeck. M. Fujiwara has received honoraria from Mochida and Eisai. K. Otsuki has received honoraria for lectures from Otsuka, Meiji, Sumitomo Pharma, Takeda, Nippon Shinyaku, and Yoshitomiyakuhin. M. Inagaki has received grants from Astellas, Eisai, Otsuka, Shionogi, Daiichi Sankyo, Sumitomo Pharma, Takeda, Mitsubishi Tanabe Pharma, Nihon Medi‐Physics, Pfizer, Fujifilm, and Mochida and has received honoraria for lectures from EA Pharma, Meiji, MSD, Viatris, Eisai, Otsuka, Sumitomo Pharma, Takeda, Eli Lilly, Nippon Shinyaku, Pfizer, Mochida, Janssen and Yoshitomiyakuhin. The other authors declare that they have no competing interests.
(© 2025 The Author(s). Psychiatry and Clinical Neurosciences Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Psychiatry and Neurology.)