Perceived risk as a barrier to appropriate diagnosis of irritable bowel syndrome

Table 1 Characteristics of respondents by risk perception of irritable bowel syndrome n (%)

	Increased risk perception (colon cancer, nutritional deficit, surgical condition, or shorter life span) (n = 983)
	No (n = 130)	Yes (n = 853)	P value1
Characteristics
Age (yr)
mean ± SD	42.55 ± 13.50	42.74 ± 12.53	0.871
29-39	54 (41.5)	371 (43.5)
40-59	62 (47.7)	377 (44.2)
≥ 60	14 (10.8)	105 (12.3)	0.730
Sex			0.908
Male	67 (51.5)	435 (51.0)
Female	63 (48.5)	418 (49.0)
Marital status			0.403
Married	92 (70.8)	645 (75.6)
Widowed/separated/divorced	1 (0.8)	10 (1.2)
Single	37 (28.4)	198 (23.2)
Educational status (yr)			0.617
≥ 13	45 (34.6)	331 (38.8)
10-12	74 (56.9)	447 (52.4)
≤ 9	11 (8.5)	75 (8.8)
Household income (monthly)			0.712
≥ $4000	21 (16.2)	153 (17.9)
$2000-3999	81 (62.3)	499 (58.5)
< $2000	28 (21.5)	201 (23.6)
Region			0.040
Urban	58 (44.6)	463 (54.3)
Rural	72 (55.4)	390 (45.7)
Hospital visit (/yr)
mean ± SD	4.68 ± 5.94	4.24 ± 4.86	0.343
0-5	96 (73.8)	679 (79.6)
6-10	24 (18.5)	104 (12.2)
≥ 11	10 (7.7)	70 (8.2)	0.141
No. of comorbidity
mean ± SD	0.28 ± 0.57	0.35 ± 0.94	0.403
0	100 (76.9)	679 (79.6)
1	26 (20.0)	107 (12.5)
≥ 2	4 (3.1)	67 (7.9)	0.016
Smoking			0.969
None	77 (59.2)	500 (58.6)
Past	15 (11.5)	105 (12.3)
Current	38 (29.2)	248 (29.1)
Problem drinking2			0.021
No	116 (89.2)	690 (80.9)
Yes	14 (10.8)	163 (19.1)

¹P values calculated from t-test for continuous variables and the chi-square test for categorical variables;

²For men, seven or more drinks on an occasion and more than two times per week; for women, five or more drinks on an occasion and more than two times per week. IBS: Irritable bowel syndrome.

Table 2 Perceived risk of irritable bowel syndrome among laypersons¹n (%)

The patient is at increased risk of…(choose EVERYTHING appropriate)	No	Yes
Colon cancer	395 (40.2)	588 (59.8)
Nutritional deficit	782 (79.6)	201 (20.4)
Surgical condition	477 (48.5)	506 (51.5)
Shorter life span	870 (88.5)	113 (11.5)
Nothing relevant	853 (86.8)	130 (13.2)
Union of answers	130 (13.2)	853 (86.8)

¹The respondents were asked: "Based upon the information provided at this point, do you believe that this patient is at increased risk of following conditions? (choose EVERYTHING appropriate)".

Table 3 Needs of diagnostic tests by risk perception of irritable bowel syndrome¹n (%)

The patient needs to be diagnosed by …(choose EVERYTHING appropriate)	Increased risk perception (colon cancer, nutritional deficit, surgical condition, or shorter life span)
	No (n = 130)	Yes (n = 853)	OR2 (95%CI)	aOR3 (95%CI)
Blood test (n = 400)	30 (23.1)	370 (43.4)	2.55 (1.66-3.92)	2.66 (1.72-4.11)
Stool examination (n = 442)	40 (30.8)	402 (47.1)	2.01 (1.35-2.98)	2.12 (1.42-3.17)
Colonoscopy (n = 781)	89 (68.5)	692 (81.1)	1.98 (1.32-2.98)	2.10 (1.38-3.18)
Abdominal ultrasound (n = 354)	25 (19.2)	329 (38.6)	2.64 (1.67-4.17)	2.70 (1.70-4.28)
Computed tomography (n = 199)	10 (7.7)	189 (22.2)	3.42 (1.76-6.64)	3.33 (1.71-6.51)
Don't need any test (n = 28)	19 (14.6)	9 (1.1)	0.06 (0.03-0.14)	0.05 (0.02-0.11)

¹The question was "In your opinion, the patient needs to be diagnosed by… (choose EVERYTHING appropriate);

²Odds ratio of "yes" referenced by "no";

³Adjusted by sex, age, area of residency, number of comorbidity, and problem drinking. CI: Confidence interval; OR: Odds ratio; aOR: Adjusted odds ratio.

Table 4 Acceptance of a positive diagnosis by risk perception of irritable bowel syndrome¹n (%)

The patient would be…(choose ONLY ONE answer)	Increased risk perception (colon cancer, nutritional deficit, surgical condition, or shorter life span)
	No (n = 130)	Yes (n = 853)	OR2 (95%CI)	aOR3 (95%CI)
Reassured (n = 288)	50 (38.5)	238 (27.9)	0.49 (0.33-0.73)	0.52 (0.34-0.78)
Not reassured (n = 646)	60 (46.2)	586 (68.7)	2.05 (1.37-3.07)	1.94 (1.29-2.93)
Still worried (n = 417)	33 (25.4)	384 (45.0)	NA	NA
Impatient of uncertainty (n = 229)	27 (20.8)	202 (23.7)	NA	NA
Have no idea (n = 49)	20 (15.4)	29 (3.4)	NA	NA

¹The question was "If a doctor diagnoses her (as) irritable bowel syndrome without any kind of diagnostic test, she would be… (choose ONLY ONE answer)";

²Odds ratio of "yes" referenced by "no";

³Adjusted by sex, age, area of residency, number of comorbidity, and problem drinking. CI: Confidence interval; OR: Odds ratio; aOR: Adjusted odds ratio; NA: Not applicable.