Short and long-term psychosocial consequences of participating in a colorectal cancer screening programme: a matched longitudinal study

Abstract

ObjectivesTo investigate the psychosocial consequences of receiving a false-positive (no abnormalities) result or being diagnosed with polyps compared with receiving a negative result in a colorectal cancer (CRC) screening programme.Design and settingThis was a longitudinal study nested in the roll-out of the Danish CRC screening programme that targets all individuals aged 50–74 years.ParticipantsIn the inclusion period (April–September 2017), all positive screenees (n=1854) were consecutively enrolled and matched 2:1:1 on sex, age (±2 years), municipality and screening date with negative screenees (n=933) and individuals not yet invited to screening (n=933).Questionnaires were sent by mail to all eligible participants in Region Zealand, Denmark, after the screening result, 2 months and 12 months after the final result.Positive screenees who did not receive the follow-up procedure were excluded.Main outcome measuresThe primary outcomes were psychosocial consequences. Outcomes were measured with the CRC screening-specific questionnaire Consequences of screening in CRC with 11 outcomes after the screening result and with 21 outcomes at the two later assessments.ResultsAfter receiving the screening result, individuals with no abnormalities, low-risk and medium-risk and high-risk polyps scored significantly worse on 8 of 11 outcomes compared with the negative screenee group. At the 12-month follow-up, the differences were still significant in 8 of 21 outcomes (no abnormalities), 4 of 21 outcomes (low-risk polyps) and 10 of 21 outcomes (medium-risk and high-risk polyps). The negative screenee group and the group not yet invited to screening differed psychosocially on 5 of 11 outcomes after the screening result, but on none of the 21 outcomes at the 2 months and 12 months follow-up.ConclusionsThe study showed that there are both short-term and long-term psychosocial consequences associated with receiving a no abnormalities result or being diagnosed with polyps. The consequences were worst for individuals diagnosed with medium-risk and high-risk polyps.

Pregnant women’s attitudes to and experiences with a smartphone-based self-test for prediction of pre-eclampsia: a qualitative descriptive study

“…A key finding was that using the app for weekly screening for PE increased worries about PE, which were magnified if the test-strip colour was perceived as changing. This is consistent with previous studies suggesting that screening can lead to anxiety 27–29. Our findings indicated that the women perceived PE as a threat to themselves and their unborn child even though they were unsure about how to define PE further.…”

“…This is consistent with previous studies suggesting that screening can lead to anxiety. [27][28][29] Our findings indicated that the women perceived PE as a threat to themselves and their unborn child even though they were unsure about how to define PE further. This is consistent with both earlier and more recent studies, finding that women typically have inadequate knowledge of PE.…”

Validation of the psychosocial consequences of screening in lung cancer questionnaire in the international lung screen trial Australian cohort

“…In breast cancer screening, more negative psychosocial consequences were noted in women who received FP results, with one study reporting persistent psychosocial consequences 12 to 14years after screening in women with FP mammograms [ 10 , 24 ]. In colorectal cancer screening programs, one Danish study reported short-term and long-term psychosocial consequences of receiving a FP or diagnosis of polyps compared to a negative screening result using a condition-specific questionnaire [ 25 ]. There was no evidence of negative impacts from invitation to a colorectal cancer screening program [ 26 ].…”

Methodological Quality of PROMs in Psychosocial Consequences of Colorectal Cancer Screening: A Systematic Review

“…Only seven articles (21.2%) across three author groups discussed the limitations of the PROMs they used. [42][43][44][45][46]59 However, this reporting was generally deficient and did not focus on the implications for results.…”