The Psychological Effects of Lung Cancer Screening on Heavy Smokers

Harris, Russell

doi:10.1001/jamainternmed.2015.3571

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…31 Psychological harm, as proposed within this framework, can potentially occur at any step of the “screening cascade,” but may be heightened at specific timepoints, such as receiving scan results or undergoing additional workup for a positive screen. 31,32 Development and further refinement of conceptual frameworks on the psychological burden of LCS can potentially yield more high-quality evidence in future research.…”

Section: Discussionmentioning

confidence: 99%

“…Although these studies provide some evidence on LCS-related psychological burden, the findings may be biased because trial participation itself may have psychological effects. 32 Furthermore, characteristics of trial participants are usually different from community nonparticipants; therefore the true magnitude of psychological burden may not be fully detected. Another important factor to consider is the context of the screening situation.…”

Section: Discussionmentioning

confidence: 99%

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Psychological Burden Associated With Lung Cancer Screening: A Systematic Review

Raz

Brown

et al. 2016

Clinical Lung Cancer

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Introduction Lung cancer screening (LCS) with low dose computed tomography (LDCT) reduces mortality and is recommended for high-risk current and former smokers. Several potential harms associated with LCS have been identified, including the potential for psychological burden. To summarize the current state of the scientific knowledge on psychological burden associated with LCS, we performed a systematic search of the contemporary quantitative and qualitative research literature. Methods We included randomized controlled trials and cohort studies that evaluated the impact of LCS with LDCT on psychological burden and health-related quality of life (HRQOL) as assessed by validated and non-validated measures. PubMed, CINAHL, PsychINFO, and Scopus were searched for English language articles published between 2004 and January 2015. Data abstraction and quality assessment were conducted by two independent reviewers. Results Thirteen studies were included that met our inclusion criteria. Overall, results were variable with some studies reporting worse psychological burden for patients with indeterminate results at pre-screening, post-screening and short-term follow-up (<6 months post-screen). These adverse effects diminished or resolved at long-term follow-up (>6 months post-screen). Conclusion LCS may be associated with short-term adverse psychological burden, particularly after a false positive result. However, these adverse effects diminished over time. The current evidence is small, with limitations in study design and use of outcome measures. More high-quality research is needed to determine the frequency, duration, and overall magnitude of LCS-related psychological burden in non-clinical trial settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psychological Burden Associated With Lung Cancer Screening: A Systematic Review

Raz

Brown

et al. 2016

Clinical Lung Cancer

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“…However, there was an apparent lack of concern about incidental findings (eg COPD) among some participants who were understandably pleased their scan showed no sign of lung cancer but in some cases regarded this an ‘all‐clear’ for their respiratory health. This suggests that incidental findings carry low risk of psychological distress which is reassuring, but also implies risk of over‐reassurance akin to ‘clear’ screening results raised by a previous study . Indeed, current smokers with an incidental finding more frequently reported cutting down on smoking rather than making a quit attempt compared with those who had indeterminate results.…”

Section: Discussionmentioning

confidence: 71%

“…This suggests that incidental findings carry low risk of psychological distress which is reassuring, but also implies risk of over-reassurance akin to 'clear' screening results raised by a previous study. 23 Indeed, current smokers with an incidental finding more frequently reported cutting down on smoking rather than making a quit attempt compared with those who had indeterminate results. Communicating incidental results may therefore be an opportunity to capitalize on the initially positive emotional response to motivate positive behaviour change that could ultimately halt disease progression.…”

Section: Discussionmentioning

confidence: 99%

Mapping the spectrum of psychological and behavioural responses to low‐dose CT lung cancer screening offered within a Lung Health Check

Kummer

Waller

Cass

et al. 2020

Health Expectations

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Background Research on the psychological impact of low‐dose computed tomography (LDCT) lung cancer screening has typically been narrow in scope and restricted to the trial setting. Objective To explore the range of psychological and behavioural responses to LDCT screening offered as part of a Lung Heath Check (LHC), including lung cancer risk assessment, spirometry testing, a carbon monoxide reading and smoking cessation advice. Methods Semi‐structured interviews were carried out with 28 current and former smokers (aged 60‐75), who had undergone LDCT screening as part of a LHC appointment and mostly received an incidental or indeterminate result (n = 23). Framework analysis was used to map the spectrum of responses participants had across the LHC appointment and screening pathway, to their LDCT results and to surveillance. Results Interviewees reported a diverse range of both positive and negative psychological responses, beginning at invitation and spanning the entire LHC appointment (including spirometry) and LDCT screening pathway. Similarly, positive behavioural responses extended beyond smoking cessation to include anticipated implications for other cancer prevention and early detection behaviours, such as symptom presentation. Individual differences in responses appeared to be influenced by smoking status and LDCT result, as well as modifiable factors including perceived risk and health status, social support, competing priorities, fatalism and perceived stigma. Conclusions The diverse ways in which participants responded to screening, both psychologically and behaviourally, should direct a broader research agenda to ensure all stages of screening delivery and communication are designed to promote well‐being, motivate positive behaviour change and maximize patient benefit.

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Qualitative Research in Clinical Epidemiology

Thompson

Schick‐Makaroff

2021

Methods in Molecular Biology

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The Psychological Effects of Lung Cancer Screening on Heavy Smokers

Cited by 4 publications

References 9 publications

Psychological Burden Associated With Lung Cancer Screening: A Systematic Review

Psychological Burden Associated With Lung Cancer Screening: A Systematic Review

Mapping the spectrum of psychological and behavioural responses to low‐dose CT lung cancer screening offered within a Lung Health Check

Qualitative Research in Clinical Epidemiology

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