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The person behind the nodule: a narrative review of the psychological impact of lung cancer screening

Lung cancer is the leading cause of cancer mortality globally, responsible for an estimated 1.76 million deaths worldwide in 2018 alone. Screening adults at high risk of lung cancer using low-dose computed tomography (LDCT) significantly reduces lung cancer mortality by finding the disease at an ear...

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Autores principales: Quaife, Samantha L., Janes, Samuel M., Brain, Kate E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182717/
https://www.ncbi.nlm.nih.gov/pubmed/34164290
http://dx.doi.org/10.21037/tlcr-20-1179
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author Quaife, Samantha L.
Janes, Samuel M.
Brain, Kate E.
author_facet Quaife, Samantha L.
Janes, Samuel M.
Brain, Kate E.
author_sort Quaife, Samantha L.
collection PubMed
description Lung cancer is the leading cause of cancer mortality globally, responsible for an estimated 1.76 million deaths worldwide in 2018 alone. Screening adults at high risk of lung cancer using low-dose computed tomography (LDCT) significantly reduces lung cancer mortality by finding the disease at an early, treatable stage. Many countries are actively considering whether to implement screening for their high-risk populations in light of the recently published Dutch-Belgian trial ‘NELSON’. In deciding whether to implement a national screening programme, policymakers must weigh up the evidence for the relative risks posed to the entire screened population, including the potential psychological burden. This narrative review aimed to critically summarise the evidence for both negative and positive psychological responses experienced throughout the LDCT screening pathway, to describe their magnitude, duration and clinical relevance, and to draw out different aspects of measurement design crucial to their interpretation. A further aim was to discuss the available evidence for individual differences in psychological response, as well as interventions designed to promote psychological well-being. In summary, there was no evidence that the LDCT screening process caused adverse psychological outcomes overall, although those receiving indeterminate and suspicious LDCT results did report clinically raised anxiety and lung cancer-specific distress in the short-term. There was early evidence that demographic factors, smoking status and screening-ineligibility could be associated with individual differences in propensity to experience distress. Qualitative data suggested health beliefs could be modifiable mediators of these individual differences, but their aetiology requires quantitative and prospective research. There was also some evidence of positive psychological responses that could be capitalised on, and of the potential for person-centred communication interventions to achieve this. Further research needs to be embedded in real-world LDCT lung cancer screening services and use condition-specific measures to monitor outcomes and test evidence-based communication interventions in promoting psychological well-being.
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spelling pubmed-81827172021-06-22 The person behind the nodule: a narrative review of the psychological impact of lung cancer screening Quaife, Samantha L. Janes, Samuel M. Brain, Kate E. Transl Lung Cancer Res Review Article on Lung Cancer Screening Lung cancer is the leading cause of cancer mortality globally, responsible for an estimated 1.76 million deaths worldwide in 2018 alone. Screening adults at high risk of lung cancer using low-dose computed tomography (LDCT) significantly reduces lung cancer mortality by finding the disease at an early, treatable stage. Many countries are actively considering whether to implement screening for their high-risk populations in light of the recently published Dutch-Belgian trial ‘NELSON’. In deciding whether to implement a national screening programme, policymakers must weigh up the evidence for the relative risks posed to the entire screened population, including the potential psychological burden. This narrative review aimed to critically summarise the evidence for both negative and positive psychological responses experienced throughout the LDCT screening pathway, to describe their magnitude, duration and clinical relevance, and to draw out different aspects of measurement design crucial to their interpretation. A further aim was to discuss the available evidence for individual differences in psychological response, as well as interventions designed to promote psychological well-being. In summary, there was no evidence that the LDCT screening process caused adverse psychological outcomes overall, although those receiving indeterminate and suspicious LDCT results did report clinically raised anxiety and lung cancer-specific distress in the short-term. There was early evidence that demographic factors, smoking status and screening-ineligibility could be associated with individual differences in propensity to experience distress. Qualitative data suggested health beliefs could be modifiable mediators of these individual differences, but their aetiology requires quantitative and prospective research. There was also some evidence of positive psychological responses that could be capitalised on, and of the potential for person-centred communication interventions to achieve this. Further research needs to be embedded in real-world LDCT lung cancer screening services and use condition-specific measures to monitor outcomes and test evidence-based communication interventions in promoting psychological well-being. AME Publishing Company 2021-05 /pmc/articles/PMC8182717/ /pubmed/34164290 http://dx.doi.org/10.21037/tlcr-20-1179 Text en 2021 Translational Lung Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Lung Cancer Screening
Quaife, Samantha L.
Janes, Samuel M.
Brain, Kate E.
The person behind the nodule: a narrative review of the psychological impact of lung cancer screening
title The person behind the nodule: a narrative review of the psychological impact of lung cancer screening
title_full The person behind the nodule: a narrative review of the psychological impact of lung cancer screening
title_fullStr The person behind the nodule: a narrative review of the psychological impact of lung cancer screening
title_full_unstemmed The person behind the nodule: a narrative review of the psychological impact of lung cancer screening
title_short The person behind the nodule: a narrative review of the psychological impact of lung cancer screening
title_sort person behind the nodule: a narrative review of the psychological impact of lung cancer screening
topic Review Article on Lung Cancer Screening
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182717/
https://www.ncbi.nlm.nih.gov/pubmed/34164290
http://dx.doi.org/10.21037/tlcr-20-1179
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