Does receiving pharmacological treatment for common chronic conditions influence cancer symptom attribution? a vignette study in England
1
Faculty of Medicine, University Vita-Salute San Raffaele, Milan, Italy
2
PhD 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, Italy
3
Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
4
Research Department of Behavioural Science and Health, University College London, London, United Kingdom
5
Centre for Primary Care Health Services Research, University of Manchester, Manchester, United Kingdom
6
Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
7
Department of Family Medicine, National University Health System, Singapore City, Singapore
8
Centre for Research on Health Systems Performance, National University of Singapore, Singapore City, Singapore
Popul. Med. 2026;8(Supplement Supplement 1):A3000
ABSTRACT
BACKGROUND:
Chronic physical or mental health conditions and their treatments can influence cancer symptom attribution, with possible disparities in timely cancer diagnosis. This study aimed to investigate whether and how using pharmacological treatments for common chronic conditions influences the attribution of symptoms potentially indicative of colorectal cancer.
METHODS:
We conducted an online vignette study including 1,404 UK residents aged 50 years+. Participants self-reported physical or mental health conditions and their pharmacological treatments. They were presented with CRC-related symptom scenarios (rectal bleeding, change in bowel habit, fatigue, or abdominal pain) and provided in free-text possible attributions for each symptom. Multivariable logistic regression was used to examine the association between treatment status and symptom attributions, adjusting for socio-demographic and clinical characteristics.
RESULTS:
More than half of the participants (58.8%) reported taking pharmacological treatments. Those on treatment were significantly less likely to attribute symptoms to cancer compared to those not on treatment (17.2% vs 23.3%; adjusted aOR 0.67, 95%CI 0.52–0.88). Participants with any chronic condition were four times more likely to attribute new symptoms to medication side effects (aOR 4.02, 95%CI 1.24–13.07). This was particularly pronounced among those treated for arthritis (aOR 2.90, 95%CI 1.64–5.17) or mental health conditions, for example, for patients with anxiety or depression (aOR 2.49, 95%CI 1.44–4.33).
CONCLUSIONS:
Attribution of potential cancer symptoms to medication side effects is significantly more common among people managing chronic conditions, which might indicate increased vulnerability to diagnostic delays. Targeted interventions to support appropriate symptom appraisal in this growing population subgroup might be necessary to facilitate timely cancer diagnosis.
Chronic physical or mental health conditions and their treatments can influence cancer symptom attribution, with possible disparities in timely cancer diagnosis. This study aimed to investigate whether and how using pharmacological treatments for common chronic conditions influences the attribution of symptoms potentially indicative of colorectal cancer.
METHODS:
We conducted an online vignette study including 1,404 UK residents aged 50 years+. Participants self-reported physical or mental health conditions and their pharmacological treatments. They were presented with CRC-related symptom scenarios (rectal bleeding, change in bowel habit, fatigue, or abdominal pain) and provided in free-text possible attributions for each symptom. Multivariable logistic regression was used to examine the association between treatment status and symptom attributions, adjusting for socio-demographic and clinical characteristics.
RESULTS:
More than half of the participants (58.8%) reported taking pharmacological treatments. Those on treatment were significantly less likely to attribute symptoms to cancer compared to those not on treatment (17.2% vs 23.3%; adjusted aOR 0.67, 95%CI 0.52–0.88). Participants with any chronic condition were four times more likely to attribute new symptoms to medication side effects (aOR 4.02, 95%CI 1.24–13.07). This was particularly pronounced among those treated for arthritis (aOR 2.90, 95%CI 1.64–5.17) or mental health conditions, for example, for patients with anxiety or depression (aOR 2.49, 95%CI 1.44–4.33).
CONCLUSIONS:
Attribution of potential cancer symptoms to medication side effects is significantly more common among people managing chronic conditions, which might indicate increased vulnerability to diagnostic delays. Targeted interventions to support appropriate symptom appraisal in this growing population subgroup might be necessary to facilitate timely cancer diagnosis.
| eISSN: | 2654-1459 |
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