"ABSTRACT

Introduction

Women with severe mental disorders (SMD) experience premature mortality, with disparities in healthcare access and quality contributing to this trend. This study aimed to analyze breast cancer screening rates in women with schizophrenia, major depressive disorder, and bipolar disorder, compared to women without SMD.

Methods

A systematic review and meta-analysis were conducted using PubMed, Embase, PsycINFO, Cochrane, and Web of Science databases. Studies were included if they examined women with SMD (schizophrenia, major depressive disorder, or bipolar disorder) who were within the age range eligible for participation in breast cancer screening programs, according to the guidelines in effect at the time and in the country where the study was conducted, and if they also reported screening rates. Odds ratios were calculated, and meta-analyses were performed using random-effects models.

Results

The review included 22 studies. Women with SMD showed significantly lower odds of mammography screening compared to women without SMD (pooled OR = 0.66, 95% CI: 0.65–0.80, p-val = < 0.0001). Subgroup meta-analyses revealed significantly reduced screening rates in women with schizophrenia (OR = 0.58, 95% CI: 0.38 – 0.88, p-val = 0.005) and major depressive disorder (OR = 0.41, 95% CI: 0.17 – 0.97, p-val = < 0.0001), but no significant difference for bipolar disorder.

Conclusion

Women with SMD, particularly schizophrenia and major depressive disorder, have lower mammography screening rates than women without a SMD diagnosis. Addressing this disparity requires targeted interventions and increased healthcare provider awareness to improve screening rates and ensure equitable access to preventive care."