Impact of Self‐Reported Long‐Term Mental Health Morbidity on Help‐Seeking and Diagnostic Testing for Bowel‐Related Cancer Symptoms: A Vignette Study

ABSTRACT Objective To investigate if pre‐existing mental health morbidity (MHM) might influence help‐seeking and willingness to undergo diagnostic investigations for potential colorectal cancer (CRC) symptoms. Methods An online vignette survey was completed by 1307 adults aged > 50 years recruite...

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Main Authors: Flavia Pennisi, Giovanni Emanuele Ricciardi, Christian vonWagner, Lauren Smith, Aradhna Kaushal, Georgios Lyratzopoulos, Samuel William David Merriel, Willie Hamilton, Gary Abel, Jose Maria Valderas, Cristina Renzi
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.70426
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author Flavia Pennisi
Giovanni Emanuele Ricciardi
Christian vonWagner
Lauren Smith
Aradhna Kaushal
Georgios Lyratzopoulos
Samuel William David Merriel
Willie Hamilton
Gary Abel
Jose Maria Valderas
Cristina Renzi
author_facet Flavia Pennisi
Giovanni Emanuele Ricciardi
Christian vonWagner
Lauren Smith
Aradhna Kaushal
Georgios Lyratzopoulos
Samuel William David Merriel
Willie Hamilton
Gary Abel
Jose Maria Valderas
Cristina Renzi
author_sort Flavia Pennisi
collection DOAJ
description ABSTRACT Objective To investigate if pre‐existing mental health morbidity (MHM) might influence help‐seeking and willingness to undergo diagnostic investigations for potential colorectal cancer (CRC) symptoms. Methods An online vignette survey was completed by 1307 adults aged > 50 years recruited through Prolific, a UK panel provider. Participants self‐reported any chronic physical or MHM. After having been presented with vignettes describing new onset symptoms (rectal bleeding or change in bowel habit), participants answered questions on symptom attribution and attitudes to investigations. Using multivariable logistic regression we examined the association between MHM and symptom attribution, intended help‐seeking, and willingness to undergo investigations, controlling for socio‐demographic factors and physical morbidities. Results Self‐reported MHM (reported by 14% of participants) was not associated with cancer symptom attribution (29% of participants with or without MHM mentioned cancer as a possible reason for rectal bleeding and 14% for change in bowel habit). Individuals with self‐reported MHM were less likely to contact a GP if experiencing a change in bowel habit (19% vs. 39%; adjusted (a)OR = 0.34, 95% CI 0.19–0.60) and to mention rectal bleeding to their GP (83% vs. 89%, aOR = 0.49, 95% CI 0.26–0.94). Although most participants would be willing to undergo a colonoscopy for these high‐risk symptoms, those with depression/anxiety were less willing (90% vs. 96%; aOR: 0.37, 95% CI 0.16–0.87). Conclusions Individuals with self‐reported MHM are less likely to seek help and less willing to undergo investigations for high‐risk symptoms. Targeted support, for example, through additional mental health nurses, might facilitate prompt cancer diagnosis for the large group of people with MHM.
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spelling doaj-art-e3e6fbebb5ce456a89a5bb5bae5582292025-08-20T01:58:46ZengWileyCancer Medicine2045-76342024-12-011323n/an/a10.1002/cam4.70426Impact of Self‐Reported Long‐Term Mental Health Morbidity on Help‐Seeking and Diagnostic Testing for Bowel‐Related Cancer Symptoms: A Vignette StudyFlavia Pennisi0Giovanni Emanuele Ricciardi1Christian vonWagner2Lauren Smith3Aradhna Kaushal4Georgios Lyratzopoulos5Samuel William David Merriel6Willie Hamilton7Gary Abel8Jose Maria Valderas9Cristina Renzi10PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine University of Pavia Pavia ItalyPhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine University of Pavia Pavia ItalyResearch Department of Behavioural Science and Health University College London London UKResearch Department of Behavioural Science and Health University College London London UKResearch Department of Behavioural Science and Health University College London London UKResearch Department of Behavioural Science and Health University College London London UKCentre for Primary Care & Health Services Research University of Manchester Manchester UKDepartment of Health and Community Sciences, Faculty of Health and Life Sciences University of Exeter Exeter UKDepartment of Health and Community Sciences, Faculty of Health and Life Sciences University of Exeter Exeter UKDepartment of Health and Community Sciences, Faculty of Health and Life Sciences University of Exeter Exeter UKSchool of Medicine Università Vita‐Salute San Raffaele Milano ItalyABSTRACT Objective To investigate if pre‐existing mental health morbidity (MHM) might influence help‐seeking and willingness to undergo diagnostic investigations for potential colorectal cancer (CRC) symptoms. Methods An online vignette survey was completed by 1307 adults aged > 50 years recruited through Prolific, a UK panel provider. Participants self‐reported any chronic physical or MHM. After having been presented with vignettes describing new onset symptoms (rectal bleeding or change in bowel habit), participants answered questions on symptom attribution and attitudes to investigations. Using multivariable logistic regression we examined the association between MHM and symptom attribution, intended help‐seeking, and willingness to undergo investigations, controlling for socio‐demographic factors and physical morbidities. Results Self‐reported MHM (reported by 14% of participants) was not associated with cancer symptom attribution (29% of participants with or without MHM mentioned cancer as a possible reason for rectal bleeding and 14% for change in bowel habit). Individuals with self‐reported MHM were less likely to contact a GP if experiencing a change in bowel habit (19% vs. 39%; adjusted (a)OR = 0.34, 95% CI 0.19–0.60) and to mention rectal bleeding to their GP (83% vs. 89%, aOR = 0.49, 95% CI 0.26–0.94). Although most participants would be willing to undergo a colonoscopy for these high‐risk symptoms, those with depression/anxiety were less willing (90% vs. 96%; aOR: 0.37, 95% CI 0.16–0.87). Conclusions Individuals with self‐reported MHM are less likely to seek help and less willing to undergo investigations for high‐risk symptoms. Targeted support, for example, through additional mental health nurses, might facilitate prompt cancer diagnosis for the large group of people with MHM.https://doi.org/10.1002/cam4.70426cancer diagnosiscolorectal cancermental disordersmental health
spellingShingle Flavia Pennisi
Giovanni Emanuele Ricciardi
Christian vonWagner
Lauren Smith
Aradhna Kaushal
Georgios Lyratzopoulos
Samuel William David Merriel
Willie Hamilton
Gary Abel
Jose Maria Valderas
Cristina Renzi
Impact of Self‐Reported Long‐Term Mental Health Morbidity on Help‐Seeking and Diagnostic Testing for Bowel‐Related Cancer Symptoms: A Vignette Study
Cancer Medicine
cancer diagnosis
colorectal cancer
mental disorders
mental health
title Impact of Self‐Reported Long‐Term Mental Health Morbidity on Help‐Seeking and Diagnostic Testing for Bowel‐Related Cancer Symptoms: A Vignette Study
title_full Impact of Self‐Reported Long‐Term Mental Health Morbidity on Help‐Seeking and Diagnostic Testing for Bowel‐Related Cancer Symptoms: A Vignette Study
title_fullStr Impact of Self‐Reported Long‐Term Mental Health Morbidity on Help‐Seeking and Diagnostic Testing for Bowel‐Related Cancer Symptoms: A Vignette Study
title_full_unstemmed Impact of Self‐Reported Long‐Term Mental Health Morbidity on Help‐Seeking and Diagnostic Testing for Bowel‐Related Cancer Symptoms: A Vignette Study
title_short Impact of Self‐Reported Long‐Term Mental Health Morbidity on Help‐Seeking and Diagnostic Testing for Bowel‐Related Cancer Symptoms: A Vignette Study
title_sort impact of self reported long term mental health morbidity on help seeking and diagnostic testing for bowel related cancer symptoms a vignette study
topic cancer diagnosis
colorectal cancer
mental disorders
mental health
url https://doi.org/10.1002/cam4.70426
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