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Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study

OBJECTIVES: Lung cancer CT screening can reduce lung cancer mortality, but high false-positive rates may cause adverse psychosocial consequences. The aim was to analyse the psychosocial consequences of false-positive lung cancer CT screening using the lung cancer screening-specific questionnaire, Co...

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Autores principales: Rasmussen, Jakob Fraes, Siersma, Volkert, Malmqvist, Jessica, Brodersen, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279658/
https://www.ncbi.nlm.nih.gov/pubmed/32503869
http://dx.doi.org/10.1136/bmjopen-2019-034682
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author Rasmussen, Jakob Fraes
Siersma, Volkert
Malmqvist, Jessica
Brodersen, John
author_facet Rasmussen, Jakob Fraes
Siersma, Volkert
Malmqvist, Jessica
Brodersen, John
author_sort Rasmussen, Jakob Fraes
collection PubMed
description OBJECTIVES: Lung cancer CT screening can reduce lung cancer mortality, but high false-positive rates may cause adverse psychosocial consequences. The aim was to analyse the psychosocial consequences of false-positive lung cancer CT screening using the lung cancer screening-specific questionnaire, Consequences of Screening in Lung Cancer (COS-LC). DESIGN AND SETTING: This study was a matched cohort study, nested in the randomised Danish Lung Cancer Screening Trial (DLCST). PARTICIPANTS: Our study included all 130 participants in the DLCST with positive CT results in screening rounds 2–5, who had completed the COS-LC questionnaire. Participants were split into a true-positive and a false-positive group and were then matched 1:2 with a control group (n=248) on sex, age (±3 years) and the time of screening for the positive CT groups or clinic visit for the control group. The true positives and false positives were also matched 1:2 with participants with negative CT screening results (n=252). PRIMARY OUTCOMES: Primary outcomes were psychosocial consequences measured at five time points. RESULTS: False positives experienced significantly more negative psychosocial consequences in seven outcomes at 1 week and in three outcomes at 1 month compared with the control group and the true-negative group (mean ∆ score >0 and p<0.001). True positives experienced significantly more negative psychosocial consequences in one outcome at 1 week (mean ∆ score 2.86 (95% CI 1.01 to 4.70), p=0.0024) and in five outcomes at 1 month (mean ∆ score >0 and p<0.004) compared with the true-negative group and the control group. No long-term psychosocial consequences were identified either in false positives or true positives. CONCLUSIONS: Receiving a false-positive result in lung cancer screening was associated with negative short-term psychosocial consequences. These findings contribute to the evidence on harms of screening and should be taken into account when considering implementation of lung cancer screening programmes. TRIAL REGISTRATION NUMBER: NCT00496977.
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spelling pubmed-72796582020-06-15 Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study Rasmussen, Jakob Fraes Siersma, Volkert Malmqvist, Jessica Brodersen, John BMJ Open Respiratory Medicine OBJECTIVES: Lung cancer CT screening can reduce lung cancer mortality, but high false-positive rates may cause adverse psychosocial consequences. The aim was to analyse the psychosocial consequences of false-positive lung cancer CT screening using the lung cancer screening-specific questionnaire, Consequences of Screening in Lung Cancer (COS-LC). DESIGN AND SETTING: This study was a matched cohort study, nested in the randomised Danish Lung Cancer Screening Trial (DLCST). PARTICIPANTS: Our study included all 130 participants in the DLCST with positive CT results in screening rounds 2–5, who had completed the COS-LC questionnaire. Participants were split into a true-positive and a false-positive group and were then matched 1:2 with a control group (n=248) on sex, age (±3 years) and the time of screening for the positive CT groups or clinic visit for the control group. The true positives and false positives were also matched 1:2 with participants with negative CT screening results (n=252). PRIMARY OUTCOMES: Primary outcomes were psychosocial consequences measured at five time points. RESULTS: False positives experienced significantly more negative psychosocial consequences in seven outcomes at 1 week and in three outcomes at 1 month compared with the control group and the true-negative group (mean ∆ score >0 and p<0.001). True positives experienced significantly more negative psychosocial consequences in one outcome at 1 week (mean ∆ score 2.86 (95% CI 1.01 to 4.70), p=0.0024) and in five outcomes at 1 month (mean ∆ score >0 and p<0.004) compared with the true-negative group and the control group. No long-term psychosocial consequences were identified either in false positives or true positives. CONCLUSIONS: Receiving a false-positive result in lung cancer screening was associated with negative short-term psychosocial consequences. These findings contribute to the evidence on harms of screening and should be taken into account when considering implementation of lung cancer screening programmes. TRIAL REGISTRATION NUMBER: NCT00496977. BMJ Publishing Group 2020-06-04 /pmc/articles/PMC7279658/ /pubmed/32503869 http://dx.doi.org/10.1136/bmjopen-2019-034682 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Respiratory Medicine
Rasmussen, Jakob Fraes
Siersma, Volkert
Malmqvist, Jessica
Brodersen, John
Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study
title Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study
title_full Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study
title_fullStr Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study
title_full_unstemmed Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study
title_short Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study
title_sort psychosocial consequences of false positives in the danish lung cancer ct screening trial: a nested matched cohort study
topic Respiratory Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279658/
https://www.ncbi.nlm.nih.gov/pubmed/32503869
http://dx.doi.org/10.1136/bmjopen-2019-034682
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