{
  "abstract": "People with pre-existing mental health disorders (PMHD) often have lower cancer screening uptake and later-stage diagnoses. It remains unclear whether these disparities persist within highly accessible universal healthcare systems without strict gatekeeping. We simultaneously investigated the associations between PMHD and both screening participation and stage at diagnosis of breast and bowel cancers within the Taiwan health service. Using nationwide National Health Insurance and Cancer Registry data covering over 99% of the population, we compared outcomes between individuals with and without PMHD. Propensity score matching was applied for the screening cohort. Adjusted odds ratios were estimated using logistic regression, with subgroup analyses for severe PMHD. Overall, PMHD was associated with higher screening participation (adjusted odds ratios [aOR]: breast = 1.04, bowel = 1.12) and reduced odds of metastatic disease at diagnosis (breast = 0.72, bowel = 0.93), although the magnitude of these associations was modest, particularly for bowel cancer. Conversely, individuals with severe PMHD had significantly lower odds of screening (breast = 0.81, bowel = 0.88) despite high outpatient use. Furthermore, while the severe group retained reduced odds of metastatic breast cancer at diagnosis (aOR = 0.79), they showed no staging advantage for bowel cancer. While Taiwan’s highly accessible universal healthcare system may contribute to a surveillance effect benefiting the general PMHD population, significant disparities persist for individuals with severe illnesses. Targeted interventions, procedural simplifications for self-administered tests, and multidisciplinary person-centred care models, may be needed to ensure health equity.",
  "abstract_shown": true,
  "affiliations": [
    "Cancer Epidemiology and Cancer Services Research, Centre for Cancer Society & Public Health, Comprehensive Cancer Centre, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom",
    "Institute of Cancer Policy, Comprehensive Cancer Centre, School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom",
    "Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yueh-Hsin Wang",
      "orcid": "0000-0002-1282-5945"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Ajay Aggarwal"
    },
    {
      "affs": [
        0
      ],
      "name": "Elizabeth A. Davies"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e4xtdvjnr3ny7.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0361617",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13712726/",
  "id": "e4xtdvjnr3ny7",
  "issns": [
    "1932-6203"
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  "landing_url": "https://doi.org/10.1371/journal.pone.0361617",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
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  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
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  "native_subjects": [
    [
      "heading",
      "Breast Cancer"
    ],
    [
      "heading",
      "Breast Tumors"
    ],
    [
      "heading",
      "Cancer Detection and Diagnosis"
    ],
    [
      "heading",
      "Cancer Screening"
    ],
    [
      "heading",
      "Cancers and Neoplasms"
    ],
    [
      "heading",
      "Colorectal Cancer"
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    [
      "heading",
      "Diagnostic Medicine"
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      "heading",
      "Health Care"
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      "heading",
      "Health Screening"
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    [
      "heading",
      "Medicine and Health Sciences"
    ],
    [
      "heading",
      "Mental Health and Psychiatry"
    ],
    [
      "heading",
      "Oncology"
    ],
    [
      "heading",
      "Outpatients"
    ],
    [
      "heading",
      "Patients"
    ],
    [
      "heading",
      "Public and Occupational Health"
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      "2730|Global Cancer Incidence and Screening"
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      "/Medicine and health sciences/Diagnostic medicine"
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      "/Medicine and health sciences/Diagnostic medicine/Cancer detection and diagnosis"
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      "plos",
      "/Medicine and health sciences/Diagnostic medicine/Cancer detection and diagnosis/Cancer screening"
    ],
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      "plos",
      "/Medicine and health sciences/Health care/Patients/Outpatients"
    ],
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      "plos",
      "/Medicine and health sciences/Mental health and psychiatry"
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      "plos",
      "/Medicine and health sciences/Oncology/Cancer detection and diagnosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancer detection and diagnosis/Cancer screening"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Breast tumors/Breast cancer"
    ],
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      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Colorectal cancer"
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      "/Medicine and health sciences/Public and occupational health/Health screening"
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  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0361617&type=printable",
  "pmcid": "PMC13712726",
  "pmid": "42945295",
  "published": "2026-10-27",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/e4xtdvjnr3ny7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:17Z",
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      "first_seen": "2026-10-31T12:23:15Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "heading:Public and Occupational Health",
      "subfield": "epidemiology-public-health"
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    {
      "field": "medicine",
      "origin": "plos:oncology",
      "subfield": "oncology"
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    {
      "field": "medicine",
      "origin": "heading:Mental Health and Psychiatry",
      "subfield": "psychiatry"
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  "title": "Disparities in screening participation and stage at diagnosis for breast and bowel cancers among individuals with pre-existing mental health disorders: A population-based study",
  "title_text": "Disparities in screening participation and stage at diagnosis for breast and bowel cancers among individuals with pre-existing mental health disorders: A population-based study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:23:15Z",
  "url": "https://research.draconitic.com/paper/e4xtdvjnr3ny7",
  "venue": "PLOS One",
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}