The impact of mental health conditions on attitudes towards help-seeking and diagnostic testing for potential ovarian cancer symptoms: An online vignette study

The impact of mental health conditions on attitudes towards help-seeking and diagnostic testing for potential ovarian cancer symptoms: An online vignette study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The impact of mental health conditions on attitudes towards help-seeking and diagnostic testing for potential ovarian cancer symptoms: An online vignette study Sophia Harmer, Christian von Wagner, Bettina Friedrich, Jose M Valderas, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8853652/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background: Mental health conditions may be associated with delayed cancer diagnosis, yet evidence remains limited. We aimed to explore if anxiety and/or depression influence symptom attribution, intended help-seeking, and attitudes towards diagnostic testing for potential ovarian cancer symptoms. Methods: A total of 1839 women aged ≥40 (889 with self-reported anxiety/depression) participated in an online survey. Participants were presented with two hypothetical scenarios (vignettes), one describing red-flag and the other describing vague ovarian cancer symptoms. 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: Compared to women without, those with anxiety/depression had lower odds of attributing vague ovarian cancer symptoms to cancer (adj. OR = 0.74; 95% CI 0.60-0.91). Additionally, they had lower odds of mentioning symptoms if seeing a nurse for another reason (red-flag symptoms: adj. OR = 0.71; 95% CI 0.56-0.90; vague symptoms: adj. OR = 0.80; 95% CI 0.63-1.00) and higher odds of dismissing vague symptoms (adj. OR = 1.32; 95% CI 1.04-1.69). Anxiety/depression was also associated with lower willingness to undergo transvaginal ultrasounds for red-flag symptoms (adj. OR = 0.61; 95% CI 0.40-0.95) and rectovaginal exams for vague symptoms (adj. OR = 0.77; 95% CI 0.59-0.99). Conclusions: The results highlight several mechanisms that could lead to delayed ovarian cancer diagnosis among women with anxiety and/or depression. To facilitate early ovarian cancer diagnosis in this population, targeted interventions are needed, including raising awareness of vague ovarian cancer symptoms, encouraging help-seeking and providing support for diagnostic investigations. Ovarian Cancer Mental Health Anxiety Depression Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 23 Mar, 2026 Reviewers agreed at journal 11 Mar, 2026 Reviewers invited by journal 09 Mar, 2026 Editor invited by journal 13 Feb, 2026 Editor assigned by journal 12 Feb, 2026 Submission checks completed at journal 12 Feb, 2026 First submitted to journal 11 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8853652","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":604470138,"identity":"dbe8290b-7967-409b-916c-0712843c5fd4","order_by":0,"name":"Sophia 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study\u003c/strong\u003e\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Ovarian Cancer, Mental Health, Anxiety, Depression ","lastPublishedDoi":"10.21203/rs.3.rs-8853652/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8853652/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Mental health conditions may be associated with delayed cancer diagnosis, yet evidence remains limited. We aimed to explore if anxiety and/or depression influence symptom attribution, intended help-seeking, and attitudes towards diagnostic testing for potential ovarian cancer symptoms.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A total of 1839 women aged ≥40 (889 with self-reported anxiety/depression) participated in an online survey. Participants were presented with two hypothetical scenarios (vignettes), one describing red-flag and the other describing vague ovarian cancer symptoms. 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.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Compared to women without, those with anxiety/depression had lower odds of attributing vague ovarian cancer symptoms to cancer (adj. OR = 0.74; 95% CI 0.60-0.91). Additionally, they had lower odds of mentioning symptoms if seeing a nurse for another reason (red-flag symptoms: adj. OR = 0.71; 95% CI 0.56-0.90; vague symptoms: adj. OR = 0.80; 95% CI 0.63-1.00) and higher odds of dismissing vague symptoms (adj. OR = 1.32; 95% CI 1.04-1.69). Anxiety/depression was also associated with lower willingness to undergo transvaginal ultrasounds for red-flag symptoms (adj. OR = 0.61; 95% CI 0.40-0.95) and rectovaginal exams for vague symptoms (adj. OR = 0.77; 95% CI 0.59-0.99).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eThe results highlight several mechanisms that could lead to delayed ovarian cancer diagnosis among women with anxiety and/or depression. To facilitate early ovarian cancer diagnosis in this population, targeted interventions are needed, including raising awareness of vague ovarian cancer symptoms, encouraging help-seeking and providing support for diagnostic investigations.\u003c/p\u003e","manuscriptTitle":"The impact of mental health conditions on attitudes towards help-seeking and diagnostic testing for potential ovarian cancer symptoms: An online vignette study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-12 16:45:31","doi":"10.21203/rs.3.rs-8853652/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-03-23T14:31:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"301214701066682848663871356927815336619","date":"2026-03-11T12:26:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-09T06:02:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-13T16:11:41+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-12T23:37:21+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-12T23:37:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Women's Health","date":"2026-02-11T15:37:58+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"78c3004c-8c94-454c-9199-d903618aa1f1","owner":[],"postedDate":"March 12th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-12T16:45:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-12 16:45:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8853652","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8853652","identity":"rs-8853652","version":["v1"]},"buildId":"veTbxFhMMB0_faC6-Wkog","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}