A Descriptive Thematic Review of Barriers, Facilitators, and Recommendations for Cancer Screening Uptake Among Community Dwelling Adults with Mental Ill-Health

Sep 22, 2026

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The much higher rate of premature cancer mortality among people with mental ill-health contributes to a 20-year reduction in life expectancy compared with the broader population. Under-screening and delays in cancer screening intensify this health inequality. This thematic review synthesizes peer-reviewed quantitative, qualitative, and mixed-methods evidence on barriers, facilitators, and recommendations to improve screening uptake among community-dwelling adults in contact with mental health services. Thirty-seven studies were reviewed using MMATv.18 and CASP.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages23

Reading Time58 min

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1. Introduction

Review A Descriptive Thematic Review of Barriers, Facilitators, and Recommendations for Cancer Screening Uptake Among Community Dwelling Adults with Mental Ill-Health Chase Bolton 1 and Sharon Lawn 1,2, * Academic Editor: Jimmy T. Efird Received: 15 December 2025 Revised: 2 February 2026 Accepted: 5 February 2026 Published: 9 February 2026 Copyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia; [bolt0104@flinders.edu.au](bolt0104@flinders.edu.au) 2 Lived Experience Australia, Adelaide, SA 5048, Australia * [Correspondence: sharon.lawn@flinders.edu.au](Correspondence: sharon.lawn@flinders.edu.au); Tel.: +61-459-098-772 Highlights Public health relevance—How does this work relate to a public health issue? • Cancers and mental health conditions are each among the greatest contributors to the global burden of disease; as comorbid conditions, they pose even greater burdens on individuals, families, healthcare resources, and communities. • Complexity across the trajectory of cancer screening and treatment for people with comorbid mental ill-health is a significant and multi-faceted public health issue, underpinned by multiple inequalities in the social determinants of health. Public health significance—Why is this work of significance to public health? • Cancer screening is a pivotal step in addressing cancer burden incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years. • Inequity of access to early cancer screening and treatment is understood as a significant contributor to the up to 20-year gap in life expectancy for people with mental ill-health. Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health? • Access to early and regular screening for cancers is vital to address disparities in health status for people with mental health conditions. • Multiple barriers to cancer screening and treatment at individual, community, health workforce, health service and system levels must be understood and addressed. Abstract The much higher rate of premature mortality from cancer among people with mental ill-health is a major contributor to 20-year reduction in life expectancy for this population, relative to the broader population. Under-screening and delays in screening for cancers are recognized as significant issues contributing to this health inequality. This thematic review explored the common barriers to delayed cancer screening, facilitators to overcome those barriers, and the associated recommendations to improve screening rates for people with mental ill-health. Inclusion criteria were peer-reviewed quantitative, qualitative or mixed methods studies and reviews, available in English, involving adults with mental ill-health (experiencing mental distress or with diagnosed mental disorder), living in the community and in contact with primary, secondary or tertiary mental health services, exploring their screening experiences for any type of cancer. The reviewed literature from 37 studies that met the inclusion criteria highlighted key themes contributing to the health disparity experienced by this population, including social determinants of health, comorbidities, and Int. J. Environ. Res. Public Health 2026, 23, 216 [https://doi.org/10.3390/ijerph23020216](https://doi.org/10.3390/ijerph23020216) health system factors. Facilitators such as trust, support, self-care, and interventions at a health system level were also highlighted. Study quality was appraised using the MMATv.18 and CASP tools. All studies that met the inclusion criteria, regardless of quality, were included in the review to provide a comprehensive analy

FAQs

What problem does this review focus on regarding cancer screening?

The review focuses on under-screening and delays in cancer screening among community-dwelling adults with mental ill-health, which contributes to a major health inequality.

What types of studies were included in the thematic review?

The review included peer-reviewed quantitative, qualitative, and mixed-methods studies and reviews available in English that examined adults with mental ill-health living in the community and experiencing cancer screening in contact with mental health services.

Which factors were highlighted as facilitators for improving screening uptake?

Facilitators highlighted include trust, support, self-care, and interventions implemented at the health system level.

Sep 22, 2026

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