The prevalence and factors for cancer screening behavior among people with severe mental illness in Hong Kong.

Phoenix Kit Han Mo,Rebecca Yuen Man Cheung,Hanyang Shen,Eddie Siu Kwan Chong,Winnie Wing Sze Mak,Paul L Reiter

doi:10.1371/journal.pone.0107237

Abstract

ObjectivesScreening is useful in reducing cancer incidence and mortality. People with severe mental illness (PSMI) are vulnerable to cancer as they are exposed to higher levels of cancer risks. Little is known about PSMI's cancer screening behavior and associated factors. The present study examined the utilization of breast, cervical, prostate, and colorectal cancer screening among PSMI in Hong Kong and to identify factors associated with their screening behaviors.Method591 PSMI from community mental health services completed a cross-sectional survey.ResultsThe percentage of cancer screening behavior among those who met the criteria for particular screening recommendation was as follows: 20.8% for mammography; 36.5% for clinical breast examination (CBE); 40.5% for pap-smear test; 12.8% for prostate examination; and 21.6% for colorectal cancer screening. Results from logistic regression analyses showed that marital status was a significant factor for mammography, CBE, and pap-smear test; belief that cancer can be healed if found early was a significant factor for pap-smear test and colorectal screening; belief that one can have cancer without having symptoms was a significant factor for CBE and pap-smear test; belief that one will have a higher risk if a family member has had cancer was a significant factor for CBE; and self-efficacy was a significant factor for CBE and pap-smear test behavior.ConclusionsCancer screening utilization among PSMI in Hong Kong is low. Beliefs about cancer and self-efficacy are associated with cancer screening behavior. Health care professionals should improve the knowledge and remove the misconceptions about cancer among PSMI; self-efficacy should also be promoted.

Highlights

Cancer as an important health issue Cancer is an important preventable cause of morbidity and mortality
The percentage of cancer screening behavior among those who met the criteria for particular screening recommendation was as follows: 20.8% for mammography; 36.5% for clinical breast examination (CBE); 40.5% for pap-smear test; 12.8% for prostate examination; and 21.6% for colorectal cancer screening
Results from logistic regression analyses showed that marital status was a significant factor for mammography, CBE, and pap-smear test; belief that cancer can be healed if found early was a significant factor for pap-smear test and colorectal screening; belief that one can have cancer without having symptoms was a significant factor for CBE and pap-smear test; belief that one will have a higher risk if a family member has had cancer was a significant factor for CBE; and self-efficacy was a significant factor for CBE and papsmear test behavior

Summary

Introduction

Cancer as an important health issue Cancer is an important preventable cause of morbidity and mortality. It is a leading cause of death in Hong Kong, accounting for 30.6% of all deaths in 2010 [1]. Colorectal, prostate, breast, and cervical cancer are important public health problems in Hong Kong, accounting for 16.6% of total cancer incidence, 10.7% of cancer incidence in men, and 24.1% and 3.2% of cancer incidence in women in 2010 respectively. The number of invasive breast cancer and cervical cancer has increased by 2.3% and 26% in Hong Kong in 2009 respectively. Type of mental illness Schizophrenia Depression Bipolar Disorder Others. Education level Primary School or below Secondary School College or above Marital Status Single Married/Cohabited Divorced/Separated/Widowed

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