Mental health conditions and attitudes towards help-seeking and diagnostic testing for potential ovarian cancer symptoms: An online vignette study
1
Behavioural Science and Health, University College London, London, United Kingdom
2
National University of Singapore, Singapore, Singapore
3
University of Exeter, Exeter, United Kingdom
4
University of Manchester, Manchester, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Mental health conditions may be associated with delayed cancer diagnosis. Evidence is scant regarding their influence on the attribution of potential ovarian cancer (OC) symptoms, help-seeking and willingness to undergo diagnostic testing. This study aimed to explore if anxiety and/or depression influence patients’ symptom attribution, intended help-seeking, and attitudes towards diagnostic testing when experiencing potential OC symptoms.
METHODS:
A total of 1839 women aged ≥40 (889 with a self-reported diagnosis of anxiety/depression) participated in an online survey. Participants were presented with two hypothetical scenarios (vignettes), one describing red-flag (vaginal bleeding, pain in pelvic area and back) and one describing vague OC symptoms (bloating, frequent urination, reaching satiety quickly). Using multivariable regression, we examined the association between anxiety/depression and symptom attribution, intended help-seeking and attitudes towards diagnostic testing (one model per outcome), adjusting for sociodemographic characteristics.
RESULTS:
Women with anxiety/depression, compared to those without, had lower odds of attributing vague OC symptoms to cancer (adjusted (a)OR=0.76; 95%CI 0.63-0.93). Additionally, they had lower odds of mentioning symptoms if seeing a nurse for another reason (red-flag symptoms: aOR=0.71; 95%CI 0.56-0.90; vague symptoms: aOR=0.80; 95%CI 0.63-1.00) and higher odds of dismissing vague symptoms (aOR=1.32; 95%CI 1.04-1.69). Anxiety/depression was also associated with lower willingness to undergo transvaginal ultrasounds for red-flag symptoms (aOR=0.61; 95%CI 0.40-0.95) and rectovaginal exams for vague symptoms (aOR=0.77; 95%CI 0.59-0.99).
CONCLUSIONS:
The results highlight several mechanisms that might lead to delayed OC diagnosis among women with anxiety and/or depression. Further research is needed to understand if there is a direct association between mental health conditions and delayed OC diagnosis. Appropriate interventions for women with anxiety and/or depression might be needed to raise awareness of vague OC symptoms, support help-seeking and encourage diagnostic testing for earlier OC diagnosis.
Mental health conditions may be associated with delayed cancer diagnosis. Evidence is scant regarding their influence on the attribution of potential ovarian cancer (OC) symptoms, help-seeking and willingness to undergo diagnostic testing. This study aimed to explore if anxiety and/or depression influence patients’ symptom attribution, intended help-seeking, and attitudes towards diagnostic testing when experiencing potential OC symptoms.
METHODS:
A total of 1839 women aged ≥40 (889 with a self-reported diagnosis of anxiety/depression) participated in an online survey. Participants were presented with two hypothetical scenarios (vignettes), one describing red-flag (vaginal bleeding, pain in pelvic area and back) and one describing vague OC symptoms (bloating, frequent urination, reaching satiety quickly). Using multivariable regression, we examined the association between anxiety/depression and symptom attribution, intended help-seeking and attitudes towards diagnostic testing (one model per outcome), adjusting for sociodemographic characteristics.
RESULTS:
Women with anxiety/depression, compared to those without, had lower odds of attributing vague OC symptoms to cancer (adjusted (a)OR=0.76; 95%CI 0.63-0.93). Additionally, they had lower odds of mentioning symptoms if seeing a nurse for another reason (red-flag symptoms: aOR=0.71; 95%CI 0.56-0.90; vague symptoms: aOR=0.80; 95%CI 0.63-1.00) and higher odds of dismissing vague symptoms (aOR=1.32; 95%CI 1.04-1.69). Anxiety/depression was also associated with lower willingness to undergo transvaginal ultrasounds for red-flag symptoms (aOR=0.61; 95%CI 0.40-0.95) and rectovaginal exams for vague symptoms (aOR=0.77; 95%CI 0.59-0.99).
CONCLUSIONS:
The results highlight several mechanisms that might lead to delayed OC diagnosis among women with anxiety and/or depression. Further research is needed to understand if there is a direct association between mental health conditions and delayed OC diagnosis. Appropriate interventions for women with anxiety and/or depression might be needed to raise awareness of vague OC symptoms, support help-seeking and encourage diagnostic testing for earlier OC diagnosis.
| eISSN: | 2654-1459 |
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