The Cancer Screening Disparity among Women With Schizophrenia by Co-occurring Chronic Physical Illness Status: A Nationwide Cohort Study in Taiwan
Journal
Schizophrenia Bulletin
ISSN
0586-7614
1745-1701
Date Issued
2025-11-24
Author(s)
Abstract
Background
To investigate the association between co-occurring chronic physical illnesses (CPIs) and breast and cervical cancer screening rates among women with schizophrenia in Taiwan.
Study Methods
This retrospective cohort study analyzed Taiwan National Health Insurance claims data from 2017 to 2019. The sample included all women with schizophrenia who were eligible for guideline-recommended breast and cervical cancer screenings. Multivariable logistic regression models examined the association between 3 major CPIs (hypertension, type 2 diabetes mellitus, and chronic kidney disease [CKD]) and receipt of cancer screening. We also assessed the relationship between the total number of CPIs (0, 1, 2, or 3) and screening uptake. Average differential effects were estimated with delta-method standard errors, adjusting for relevant sociodemographic and clinical covariates.
Study Results
Among 22 876 eligible women for breast cancer screening and 38 673 for cervical cancer screening, multivariable analyses showed that hypertension, diabetes, and CKD were each associated with increased probability of receiving mammography (4, 6, and 5 percentage points, respectively; all P < .001), and Pap tests (4, 3, and 4 percentage points, respectively; all P < .001). A greater number of CPIs was also associated with statistically significantly higher rates of both cancer screenings.
Conclusions
Women with schizophrenia and co-occurring CPIs in Taiwan had higher rates of breast and cervical cancer screenings compared to women with schizophrenia only. Interventions to improve screening uptake may need to prioritize women who are less engaged with the physical healthcare system.
Subjects
cancer screening
chronic kidney disease
diabetes
hypertension
multiple chronic conditions
schizophrenia
Publisher
Oxford University Press (OUP)
Type
journal article