Predictors of cancer screening among Black and White Maryland Medicaid enrollees with serious mental illness.

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Bibliographic Details
Title:	Predictors of cancer screening among Black and White Maryland Medicaid enrollees with serious mental illness.
Authors:	Murphy, Karly A. (AUTHOR), Daumit, Gail L. (AUTHOR), McGinty, Emma E. (AUTHOR), Stone, Elizabeth M. (AUTHOR), Kennedy‐Hendricks, Alene (AUTHOR)
Source:	Psycho-Oncology. Dec2021, Vol. 30 Issue 12, p2092-2098. 7p. 2 Charts.
Subjects:	Early detection of cancer, Mental illness, Prostate cancer, Primary care, Colorectal cancer, Breast cancer
Abstract:	Background: Cancer is the second leading cause of death for people with serious mental illness (SMI), such as schizophrenia and bipolar disorder. People with SMI receive cancer screenings at lower rates than the general population. Aims: We sought to identify factors associated with cancer screening in a publicly insured population with SMI and stratified by race, a factor itself linked with differential rates of cancer screening. Materials and Methods: We used Maryland Medicaid administrative claims data (2010–2018) to examine screening rates for cervical cancer (N = 40,622), breast cancer (N = 9818), colorectal cancer (N = 19,306), and prostate cancer (N = 4887) among eligible Black and white enrollees with SMI. We examined individual‐level socio‐demographic and clinical factors, including co‐occurring substance use disorder, medical comorbidities, psychiatric diagnosis, obstetric‐gynecologic and primary care utilization, as well as county‐level characteristics, including metropolitan status, mean household income, and primary care workforce capacity. Generalized estimating equations with a logit link were used to examine the characteristics associated with cancer screening. Results: Compared with white enrollees, Black enrollees were more likely to receive screening for cervical cancer (AOR: 1.18; 95% CI: 1.15‐1.22), breast cancer (AOR: 1.27; 95% CI: 1.19‐1.36), and colorectal cancer (AOR: 1.07; 95% CI: 1.02‐1.13), while similar rates were observed for prostate cancer screening (AOR: 1.06; 95% CI: 0.96‐1.18). Primary care utilization and longer Medicaid enrollment were positively associated with cancer screening while co‐occurring substance use disorder was negatively associated with cancer screening. Conclusion: Improving cancer screening rates among populations with SMI should focus on facilitating continuous insurance coverage and access to primary care. Key points: Cancer screening rates are low among Medicaid‐enrolled adults with serious mental illness (SMI)Black Medicaid enrollees with SMI were more likely than white enrollees to receive cervical, breast, and colorectal cancer screeningsMany of the same key factors were associated with cancer screening among both Black and white enrolleesPrimary care utilization, medical comorbidity status, and more years of continuous Medicaid enrollment were positively associated with higher rates of cancer screening. Having a co‐occurring substance use disorder and living in smaller counties with lower mean incomes were negative ly associated with cancer screeningImproving cancer screening rates among people with SMI should focus on facilitating continuous insurance coverage and access to primary care [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Background: Cancer is the second leading cause of death for people with serious mental illness (SMI), such as schizophrenia and bipolar disorder. People with SMI receive cancer screenings at lower rates than the general population. Aims: We sought to identify factors associated with cancer screening in a publicly insured population with SMI and stratified by race, a factor itself linked with differential rates of cancer screening. Materials and Methods: We used Maryland Medicaid administrative claims data (2010–2018) to examine screening rates for cervical cancer (N = 40,622), breast cancer (N = 9818), colorectal cancer (N = 19,306), and prostate cancer (N = 4887) among eligible Black and white enrollees with SMI. We examined individual‐level socio‐demographic and clinical factors, including co‐occurring substance use disorder, medical comorbidities, psychiatric diagnosis, obstetric‐gynecologic and primary care utilization, as well as county‐level characteristics, including metropolitan status, mean household income, and primary care workforce capacity. Generalized estimating equations with a logit link were used to examine the characteristics associated with cancer screening. Results: Compared with white enrollees, Black enrollees were more likely to receive screening for cervical cancer (AOR: 1.18; 95% CI: 1.15‐1.22), breast cancer (AOR: 1.27; 95% CI: 1.19‐1.36), and colorectal cancer (AOR: 1.07; 95% CI: 1.02‐1.13), while similar rates were observed for prostate cancer screening (AOR: 1.06; 95% CI: 0.96‐1.18). Primary care utilization and longer Medicaid enrollment were positively associated with cancer screening while co‐occurring substance use disorder was negatively associated with cancer screening. Conclusion: Improving cancer screening rates among populations with SMI should focus on facilitating continuous insurance coverage and access to primary care. Key points: Cancer screening rates are low among Medicaid‐enrolled adults with serious mental illness (SMI)Black Medicaid enrollees with SMI were more likely than white enrollees to receive cervical, breast, and colorectal cancer screeningsMany of the same key factors were associated with cancer screening among both Black and white enrolleesPrimary care utilization, medical comorbidity status, and more years of continuous Medicaid enrollment were positively associated with higher rates of cancer screening. Having a co‐occurring substance use disorder and living in smaller counties with lower mean incomes were negative ly associated with cancer screeningImproving cancer screening rates among people with SMI should focus on facilitating continuous insurance coverage and access to primary care [ABSTRACT FROM AUTHOR]
ISSN:	10579249
DOI:	10.1002/pon.5815