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Mental Illness Is Not Associated with Adherence to Colorectal Cancer Screening: Results from the California Health Interview Survey

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Abstract

Background

Colorectal cancer is the second leading cause of cancer-specific death in the USA. Evidence suggests people with mental illness are less likely to receive preventive health services, including cancer screening. We hypothesized that mental illness is a risk factor for non-adherence to colorectal cancer-screening guidelines.

Methods

We analyzed results of the 2007 California Health Interview Survey to test whether mental illness is a risk factor for non-adherence to colorectal cancer-screening recommendations among individuals age 50 or older (N = 15,535). This cross-sectional dataset is representative of California. Screening was defined as either fecal occult blood testing during the preceding year, sigmoidoscopy, or colonoscopy during the preceding 5 years. Mental illness was identified using the Kessler K6 screening tool. Associations were evaluated using weighted multivariate logistic regressions.

Results

Mental illness was not associated with colorectal cancer-screening adherence (OR 0.89; 95% CI 0.63–1.25). Risk factors for non-adherence included being female (OR 1.25; 95% CI 1.09–1.44), delaying accessing health care during the previous year (OR 1.89; 95% CI 1.56–2.29).

Conclusion

Unlike previous studies, this study did not find a relationship between mental illness and colorectal cancer-screening adherence. This could be due to differences in study populations. State-specific healthcare policies involving care coordination for individuals with mental illness could also influence colorectal cancer-screening adherence in California.

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References

  1. Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin. 2001;51:15–36.

    Article  CAS  PubMed  Google Scholar 

  2. Smith RA, von Eschenbach AC, Wender R, et al. American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. CA Cancer J Clin. 2001;51:38–75.

    Article  CAS  PubMed  Google Scholar 

  3. Meissner HI, Breen N, Klabunde CN, Vernon SW. Patterns of colorectal cancer screening uptake among men and women in the United States. Cancer Epidemiol Biomark Prev. 2006;15:389–394.

    Article  Google Scholar 

  4. Smith RA, Cokkinides V, Eyre HJ. Cancer screening in the United States, 2007: a review of current guidelines, practices, and prospects. CA Cancer J Clin. 2007;57:90–104.

    Article  CAS  PubMed  Google Scholar 

  5. Klabunde CN, Vernon SW, Nadel MR, Breen N, Seeff LC, Brown ML. Barriers to colorectal cancer screening: a comparison of reports from primary care physicians and average-risk adults. Med Care. 2005;43:939–944.

    Article  PubMed  Google Scholar 

  6. Druss BG, Zhao L, Von Esenwein S, Morrato EH, Marcus SC. Understanding excess mortality in persons with mental illness: 17-year follow up of a nationally representative US survey. Med Care. 2011;49:599–604.

    Article  PubMed  Google Scholar 

  7. Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis. 2006;3:A42.

    PubMed  PubMed Central  Google Scholar 

  8. Druss BG. The mental health/primary care interface in the United States: history, structure, and context. Gen Hosp Psychiatry. 2002;24:197–202.

    Article  PubMed  Google Scholar 

  9. Leigh H, Stewart D, Mallios R. Mental health and psychiatry training in primary care residency programs: part II. What skills and diagnoses are taught, how adequate, and what affects training directors’ satisfaction? Gen Hosp Psychiatry. 2006;28:195–204.

    Article  PubMed  Google Scholar 

  10. Berren MR, Santiago JM, Zent MR, Carbone CP. Health care utilization by persons with severe and persistent mental illness. Psychiatr Serv. 1999;50:559–561.

    Article  CAS  PubMed  Google Scholar 

  11. Ionescu-Ittu R, McCusker J, Ciampi A, et al. Continuity of primary care and emergency department utilization among elderly people. CMAJ. 2007;177:1362–1368.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Howard LM, Barley EA, Davies E, et al. Cancer diagnosis in people with severe mental illness: practical and ethical issues. Lancet Oncol. 2010;11:797–804.

    Article  PubMed  Google Scholar 

  13. Kodl MM, Powell AA, Noorbaloochi S, Grill JP, Bangerter AK, Partin MR. Mental health, frequency of healthcare visits, and colorectal cancer screening. Med Care. 2010;48:934–939.

    Article  PubMed  Google Scholar 

  14. Xiong GL, Bermudes RA, Torres SN, Hales RE. Use of cancer-screening services among persons with serious mental illness in Sacramento County. Psychiatr Serv. 2008;59:929–932.

    Article  PubMed  Google Scholar 

  15. Marder SR, Essock SM, Miller AL, et al. Physical health monitoring of patients with schizophrenia. Am J Psychiatry. 2004;161:1334–1349.

    Article  PubMed  Google Scholar 

  16. UCLA Center for Health Policy Research. California Health Interview Survey: methodology briefs, papers, and reports. http://healthpolicy.ucla.edu/chis/design/Pages/methodology.aspx. Updated 2012. Accessed 27 April 2015.

  17. Rex DK, Johnson DA, Anderson JC, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. Am J Gastroenterol. 2009;104:739–750.

    Article  PubMed  Google Scholar 

  18. Kessler RC, Barker PR, Colpe LJ, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003;60:184–189.

    Article  PubMed  Google Scholar 

  19. Croft JB, Mokdad AH, Power AK, Greenlund KJ, Giles WH. Public health surveillance of serious psychological distress in the United States. Int J Public Health. 2009;54:4–6.

    Article  PubMed  Google Scholar 

  20. Mandelblatt JS, Yabroff KR, Kerner JF. Equitable access to cancer services: a review of barriers to quality care. Cancer. 1999;86:2378–2390.

    Article  CAS  PubMed  Google Scholar 

  21. Andersen R. A behavioral model of families’ use of health services. Chicago, IL: University of Chicago, Center for Health Administration Studies; 1968.

    Google Scholar 

  22. Aday LA, Andersen RM, Fleming GV. Health Care in the US: equitable for whom?. Beverly Hills, CA: Sage; 1980.

    Google Scholar 

  23. Sentell T, Braun KL, Davis J, Davis T. Colorectal cancer screening: low health literacy and limited English proficiency among Asians and whites in California. J Health Commun. 2013;18:242–255.

    Article  PubMed  PubMed Central  Google Scholar 

  24. SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc.

  25. SAS Institute Inc. SAS Version 9.4, Cary, NC: SAS Institute Inc.; 2000.

  26. Xiang X. Serious psychological distress as a barrier to cancer screening among women. Womens Health Issues. 2015;25:49–55.

    Article  PubMed  Google Scholar 

  27. Maxwell AE, Crespi CM. Trends in colorectal cancer screening utilization among ethnic groups in California: are we closing the gap? Cancer Epidemiol Biomarkers Prev. 2009;18:752–759.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We would like to acknowledge Dr. Cecilia Patino-Sutton and Dr. Jonathan Samet for their guidance in the development of this manuscript.

Funding

At the time of the research, Drs. Siantz and Wu were TL1 Scholars and Drs. Shiroshi and Idos are KL2 Scholars awarded through Southern California Clinical and Translational Science Institute at the University of Southern California, Keck School of Medicine. The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through Grant Awards TL1TR000132 and KL2TR000131. The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.

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Authors and Affiliations

  1. Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA

    Elizabeth Siantz

  2. MD/PhD Program, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, KAM 200, Los Angeles, CA, 90089, USA

    Brian Wu

  3. Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St. Second Floor Imaging, Los Angeles, CA, 90033, USA

    Mark Shiroishi

  4. Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA

    Hita Vora

  5. Department of Gastroenterology and Hepatology, Keck School of Medicine, University of Southern California, 1520 San Pablo St. Ste 1000, Los Angeles, CA, 90033, USA

    Gregory Idos

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  1. Elizabeth Siantz
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  2. Brian Wu
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  3. Mark Shiroishi
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  4. Hita Vora
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  5. Gregory Idos
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Corresponding author

Correspondence to Elizabeth Siantz.

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Study authors have no conflicts of interest to report.

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Siantz, E., Wu, B., Shiroishi, M. et al. Mental Illness Is Not Associated with Adherence to Colorectal Cancer Screening: Results from the California Health Interview Survey. Dig Dis Sci 62, 224–234 (2017). https://doi.org/10.1007/s10620-016-4366-0

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  • DOI: https://doi.org/10.1007/s10620-016-4366-0

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