Short-term health-related quality of life consequences in a lung cancer CT screening trial (NELSON)

Abstract

BACKGROUND: In lung cancer CT screening, participants often have an indeterminate screening result at baseline requiring a follow-up CT. In subjects with either an indeterminate or a negative result after screening, we investigated whether health-related quality of life (HRQoL) changed over time and differed between groups in the short term. METHODS: A total of 733 participants in the NELSON trial received four questionnaires: T0, before randomisation; T1, 1 week before the baseline screening; T2, 1 day after the screening; and T3, 2 months after the screening results but before the 3-month follow-up CT. HRQoL was measured as generic HRQoL (the 12-item Short Form, SF-12; the EuroQol questionnaire, EQ-5D), anxiety (the Spielberger State-Trait Anxiety Inventory, STAI-6), and lung-cancer-specific distress (the Impact of Event Scale, IES). For analyses, repeated-measures analysis of variance was used, adjusted for covariates. RESULTS: Response to each questionnaire was 88% or higher. Scores on SF-12, EQ-5D, and STAI-6 showed no clinically relevant changes over time. At T3, IES scores that were clinically relevant increased after an indeterminate result, whereas these scores showed a significant decrease after a negative result. At T3, differences in IES scores between the two baseline result groups were both significant and clinically relevant (Po0.01). CONCLUSION: This longitudinal study among participants of a lung cancer screening programme showed that in the short term recipients of an indeterminate result experienced increased lung-cancer-specific distress, whereas the HRQoL changes after a negative baseline screening result may be interpreted as a relief.

The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer

“…83,84 The psychosocial impact of LDCT screening for lung cancer has been examined in controlled trials outside the UK, in terms of effects of both trial allocation and screening results. [85][86][87][88][89][90][91] Overall, evidence from these trials suggests that LDCT screening does not produce long-term anxiety or other adverse effects that could deter high-risk individuals from further help-seeking or future participation in a lung screening programme. However, it is important to examine psychosocial effects within the UKLS context to ensure that any future lung screening programme is tailored to the specific needs of the UK high-risk population.…”

Elevated distress among patients undergoing screening for lung cancer

“…[22] Only a limited number of studies to date, however, have reported on the presence of psychological factors in a high-risk lung cancer screening population. [8,23] Of these, the main focus has been predominantly on stress related to awaiting results [23] and/or the anxiety associated with the presence of indeterminate findings. [3,8,9] Byrne et al evaluated the psychological impact of lung cancer screening in 400 patients using surveys collected before and after screening, at 6 and 12 months.…”

“…[8,23] Of these, the main focus has been predominantly on stress related to awaiting results [23] and/or the anxiety associated with the presence of indeterminate findings. [3,8,9] Byrne et al evaluated the psychological impact of lung cancer screening in 400 patients using surveys collected before and after screening, at 6 and 12 months. The study data included demographic information, state/trait anxiety, fear of cancer and perceived risk of lung cancer.…”

“…[2] Although a strong evidence base provided by the National Lung Screening Trial (NLST) [3] and others [4][5][6][7] has demonstrated the utility and efficacy of LDCT for the early detection of lung cancer among high-risk patients, limited data are available describing the prevalence of distress in the lung cancer screening population. [8][9][10][11][12][13] Two reports have described issues relating to the impact of lung cancer screening on health-related quality of life, [8,13] however, the level of distress experienced by lung cancer screening patients has not been well established.…”

Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

“…A sample of Dutch and Belgian persons (50-75 years old) registered in population registries were inquired about their health and smoking behaviour [24]. Participants who had smoked ≥15 cigarettes per day for 25 years or ≥10 cigarettes for 30 years and were current smokers or had quit <10 years ago were included.…”