Cancer screening in patients with severe psychiatric disorders in France: Towards a coordinated and inclusive approach.

BACKGROUND

The close link between mental health and physical health is evident in patients with severe psychiatric disorders (SPD), such as schizophrenia and bipolar disorder. SPD is associated with a reduction in life expectancy, due to excess mortality from cardiovascular disease and cancer. In patients with SPD, reduced access to cancer screening programs, due to cognitive, organisational and social barriers, leads to late detection and worse prognosis.

OBJECTIVES

The objective was to identify the barriers and facilitators to systematic cancer screening in patients with SPD, with a focus on the role of general practitioners (GPs) in improving access to preventive care.

METHOD: This study was conducted in the Finistère department, France. A qualitative study based on semi-structured interviews with GPs, recorded, anonymised, transcribed verbatim, and analysed using a grounded theory approach.

RESULTS

From October 2023 to February 2024, 25 GPs were interviewed. The analysis highlighted 3 areas for improving access to cancer screening: logistic support, active involvement of the family and professional support networks and coordination among the healthcare providers. Barriers included the patients' lack of autonomy, difficulties in accessing transport, precariousness and complexity of the screening process, particularly for at-home screening tests. Family and friends play a key role, but remain vulnerable to caregiver burnout.

CONCLUSION

These results confirm the importance of a multi-professional and integrative approach, with GPs playing a central role in addressing the specific vulnerabilities of this population. More research, involving patients, caregivers and psychiatric teams, is needed to co-construct appropriate, sustainable and ethically sound solutions.