Women who suffer from mental illness have twice the risk of developing cervical cancer as they are less likely to attend their smear tests, according to a new study.

The observational study at Karolinska Institutet in Sweden, published in The Lancet, involved more than four million women born between 1940 and 1995.

Researchers compared women diagnosed by a specialist with mental illness, neuropsychiatric disability or substance abuse with women without these diagnoses.

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The risk of cervical cancer and precancerous cervical lesions, as well as their participation in screening programmes, were then calculated.

“Our study identified a high-risk group that needs extra attention if we’re to succeed in eliminating cervical cancer,” says one of the study’s first authors Kejia Hu, postdoc researcher at the Institute of Environmental Medicine at Karolinska Institutet.

She added that the results suggest women with these diagnoses “participate more seldom in screening programmes at the same time as they have a higher incidence of lesions in the cervix”.

“We thus found that they have twice the risk of developing cervical cancer.”

An elevated risk was observed for all diagnoses – but the greatest association was noted for substance abuse.

According to the researchers, women with mental illness should be made more aware of the need to attend their gynaecological screenings.

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“It would lower their risk of cancer,” said another one of the paper’s authors, Karin Sundström, senior researcher at the Department of Laboratory Medicine, Karolinska Institutet.

“Similarly, if healthcare professionals are more aware of the cancer risk in these patients, they can step up preventative measures and consider how these could be delivered to potentially under-served patients.”

It comes after the WHO approved a global strategy for eliminating cervical cancer as a women’s health problem in May 2020.

Part of the strategy is the requirement that 70% of women are screened for the disease at least once before age 35 and twice before age 45.

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