Mental Illness Delayed Colorectal Cancer Diagnosis in England
Douglas K. Rex, MD, MASGE, reviewing Benitez Majano S, et al. JAMA Netw Open Oct 3.
This study evaluated 3766 patients with colon cancer in the U.K., of whom 16.5% had preexisting mental health morbidities (MHMs) recorded in their primary care notes the year before cancer diagnosis. Of the recorded MHMs, 90.2% indicated anxiety or depression. Patients without MHM comprised 83.5% of the cohort.
Patients with MHM were less likely to have recorded red-flag symptoms or signs (eg, rectal bleeding, change in bowel habit, or anemia) in the 2 years before cancer diagnosis (49.4% vs 57.5%). Among the 2115 patients with recorded red-flag symptoms or signs, patients with MHM were 28% less likely to be referred to a specialist within 2 weeks, had a median time to cancer diagnosis of 326 days versus 133 days for patients without MHM, and were more likely to have an emergency cancer diagnosis (29.2% vs 18.1%).
COMMENTMany factors could account for these differences, but the findings underscore the need to aggressively promote screening and evaluate colorectal symptoms in adult patients with mental illness.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Benitez Majano S, Lyratzopoulos G, de Wit NJ, et al. Mental health morbidities and time to cancer diagnosis among adults with colon cancer in England. JAMA Netw Open 2022;5:e2238569. (https://doi.org/10.1001/jamanetworkopen.2022.38569)
