Women with mental health or substance abuse problems face an increased risk of developing cervical cancer, the results of a new study indicate.

Researchers in Sweden carried out an observational study involving over four million women born between 1940 and 1995. They calculated the risk of cervical cancer and precancerous cervical lesions in this population, as well as participation in screening programmess for cervical cancer.

Women who abused substances or who had been clinically diagnosed with a mental illness or neuropsychiatric disability were compared to women not affected by these issues or illnesses.

“Our results suggest that 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,” explained the study’s first author, Dr Kejia Hu, a postdoc researcher at the Institute of Environmental Medicine at Karolinska Institutet

An increased risk was observed for all diagnoses, but the greatest association was noted for substance abuse.

“Our study identified a high-risk group that needs extra attention if we’re to succeed in eliminating cervical cancer,” Dr Hu insisted.

The researchers noted that in May 2020, the World Health Organization approved a global strategy for eliminating cervical cancer. Part of that strategy is a requirement that 70% of women are screened for the disease at least once before the age of 35 and twice before the age of 45. However, they pointed out that inequality of care is one of the major hurdles to this objective.

They said that those with mental health or substance use issues need to be made more aware of the importance of undergoing regular gynaecological screening.

“It would lower their risk of cancer. 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,” commented one of the study’s authors, senior researcher Karin Sundström of the Karolinska Institutet.

The researchers acknowledged that they did not have access to full data about the participants’ other cervical cancer risk factors, such as smoking. However, they said that the strength of this study lies in the size of the cohort and the long period of time that participants were studied.

The findings are published in the journal, The Lancet Public Health, and can be viewed here.