Experiences of general practitioners and their influence on organized cancer screening in patients with severe psychiatric disorders: A qualitative study

Background Schizophrenia and bipolar disorder are severe psychiatric disorders (SPD) that concern 0.4% and 2% of the general population, respectively. In patients with SPD, life expectancy is reduced by approximately 13 years compared with the general population and cancer is the second leading cause of death. However, individuals with SPD are less likely to benefit from organized cancer screening programs. The aim of this study was to describe the general practitioners' perceptions and experiences of patients with SPD and their effects on the adherence to organized cancer screening. Method This study was conducted in the Finistère department, France. A qualitative study based on semi-structured interviews, inspired by the grounded theory, were carried out with general practitioners who follow patients with schizophrenia or bipolar disorder. The interviews were recorded, transcribed, and analyzed using an inductive thematic approach. Results Twenty-five interviews were conducted between October 2023 and February 2024. The interviewed general practitioners discussed the difficulties they encountered in establishing a strong therapeutic relationship with patients living with SPD. They described the challenges posed by psychiatric care, and also their own prejudices and the possible repercussions on these patients' access to organized cancer screening. Conclusion This study helps to explain the unequal access to organized cancer screening by patients with mental disorders. The results highlight the need of multidisciplinary and personalized support for these patients. It should be important to assess the impact of a systematic preventive health examination at the start of psychiatric care.