A record-linkage study assessing the influence of mental illness on breast screening uptake in Northern Ireland.

Cancer places a huge burden on the healthcare system. It is amongst the leading causes of morbidity and mortality worldwide, with approximately 14 million new cases and 8.2 million cancer related deaths in 2012. Screening of the more susceptible population is the most effective method of detecting cancer early and subsequently achieving more positive treatment outcomes. However, large variations in screening uptake rates have been identified as a central factor contributing to avoidable cancer deaths. Lower screening uptake rates have been previously associated with a number of factors but are most significantly identified in individuals with lower socio-economic status, those from ethnic minorities, and those without access to car.

One potentially significant factor which may contribute to these gradients in screening uptake is the mental health status of a patient. Compared to the general population, patients with a mental illness have a significantly reduced life expectancy, suffering increased morbidity and mortality from cardiovascular disease, respiratory disease, diabetes, and cancer. A number of reviews have already identified inequities in the provision of healthcare to patients with mental illness who have cancer, but it remains unclear whether this finding extends to routine cancer screening in the United Kingdom.

This study aims to:

  • Determine whether poor mental health is associated with lower cancer screening uptake in the Northern Irish population
  • Determine if screening uptake varies by mental health condition
  • Determine the socio-economic gradients in the uptake of breast screening in 2011-2014, and to compare this against the previously published gradients for 2001-2004


Publications and Outputs:

Ross E, Maguire A, Donnelly M, Mairs A, Hall C, O’Reilly D. Does poor mental health explain socio-demographic gradients in breast cancer screening uptake? A population-based study, European Journal of Public Health, Volume 30, Issue 3, June 2020, Pages 396–401, https://doi.org/10.1093/eurpub/ckz220

Ross E, Maguire A, Donnelly M, Mairs A, Hall C, O’Reilly D. Disability as a predictor of breast cancer screening uptake: A population-based study of 57,328 women. https://doi.org/10.1177/0969141319888553

NILS Case study – Lower attendance to breast screening in those women with chronic disabilities and self-reported poor mental health

Research Team: Dr Dermot O’Reilly, Miss Emma Ross, Dr Michael Donnelly and Dr Aideen Maguire
Database: NILS
Project Status: Complete
Organisation(s): Queen’s University Belfast