Attribution of colorectal cancer symptoms to medications for pre-existing chronic conditions: a secondary analysis of a vignette study in England

OBJECTIVE: To investigate the likelihood of attributing colorectal cancer (CRC) symptoms to medications for chronic conditions. METHODS: The online vignette survey included 1287 participants aged ≥50 years, with quota sampling to recruit sufficient participants with type 2 diabetes. Participants self-reported chronic conditions and answered questions on symptom attribution and help-seeking, after reading vignettes describing new-onset rectal bleeding or change in bowel habit. Using multivariable logistic regression, we analyzed the association between specific conditions and attributing new-onset CRC symptoms to medications, controlling for demographics. RESULTS: Among participants, 25% reported type 2 diabetes, 31% being overweight, 25% hypertension and 22% arthritis. Participants with diabetes, versus those without, had a higher likelihood of attributing change in bowel habit to medications [7% vs 3%; adjusted Odds Ratio (aOR) 2.55, Confidence Interval (95% CI) 1.30-5.00]. This was also the case for participants reporting being overweight (7% vs 2%; aOR 2.36, 95% CI 1.25-4.44), arthritis (8% vs 3%; aOR 2.27, 95% CI 1.19-4.35), but not for hypertension. No significant association was found regarding attribution of rectal bleeding to medications. CONCLUSIONS: Patients with common chronic conditions have a higher likelihood of attributing change in bowel habit to medications. Tailored information is needed for these patients, encouraging them to discuss any new symptom with their doctor.