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



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.



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).



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.
Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA. esiantz@ucsd.edu.
Elizabeth
0000-0001-8305-3818
E
Siantz
MD/PhD Program, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, KAM 200, Los Angeles, CA, 90089, USA.
Brian
B
Wu
Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St. Second Floor Imaging, Los Angeles, CA, 90033, USA.
Mark
M
Shiroishi
Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.
Hita
H
Vora
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
G
Idos
D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009780:Occult Blood; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012737:Sex Factors; D012812:Sigmoidoscopy
Cancer screening; Health disparities; Vulnerable populations