Do no harm: no psychological harm from colorectal cancer screening

Benedicte Kirkøen; Paula Berstad; Edoardo Botteri; Tone Lise Åvitsland; Alvilde Maria Ossum; Thomas de Lange; Geir Hoff; Tomm Bernklev

doi:10.1038/bjc.2016.14

Do no harm: no psychological harm from colorectal cancer screening

Br J Cancer. 2016 Mar 1;114(5):497-504. doi: 10.1038/bjc.2016.14. Epub 2016 Feb 11.

Authors

Benedicte Kirkøen^{1

2}, Paula Berstad^{1

3}, Edoardo Botteri^{1

4}, Tone Lise Åvitsland⁵, Alvilde Maria Ossum⁶, Thomas de Lange^{1

5}, Geir Hoff^{1

3

7}, Tomm Bernklev^{2

3}

Affiliations

¹ Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.
² Institute of Clinical Medicine, University of Oslo, P.O. box 1171 Blindern, 0318 Oslo, Norway.
³ Department of Research and Development, Telemark Hospital Trust, 3710 Skien, Norway.
⁴ Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
⁵ Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, P.O. box 800, 3004 Drammen, Norway.
⁶ Department of Gastroenterology, Østfold Hospital Trust, P.O. box 300, 1714 Grålum, Norway.
⁷ Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, P.O. box 1089 Blindern, 0318 Oslo, Norway.

Abstract

Background: Participation in cancer screening programmes might cause worries in the population outweighting the benefits of reduced mortality. The present study aimed to investigate possible psychological harm of participation in a colorectal cancer (CRC) screening pilot in Norway.

Methods: In a prospective, randomised trial participants (aged 50-74 years) were invited to either flexible sigmoidoscopy (FS) screening, faecal immunochemical test (FIT), or no screening (the control group; 1 : 1: 1). Three thousand two hundred and thirteen screening participants (42% of screened individuals) completed the Hospital Anxiety and Depression Scale questionnaire as well as the SF-12-a health-related quality of life (HRQOL) questionnaire when invited to screening and when receiving the screening result. A control group was invited to complete the questionnaires only. Two thousand six hundred and eighteen control participants (35% of invited individuals) completed the questionnaire.

Results: A positive screening result did not increase participants' level of anxiety or depression, or decrease participants' level of HRQOL. Participants who received a negative result reported decreased anxiety and improvement on some HRQOL dimensions. However, no change was considered to be of clinical relevance.

Conclusion: The current study showed no clinically relevant psychological harm of receiving a positive CRC screening result or of participating in FS or FIT screening, in a Norwegian population.

Trial registration: ClinicalTrials.gov NCT01538550.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Anxiety / psychology*
Colorectal Neoplasms / diagnosis*
Depression / psychology*
Early Detection of Cancer / psychology*
Female
Humans
Male
Middle Aged
Norway
Occult Blood
Quality of Life
Sigmoidoscopy / psychology
Stress, Psychological / psychology*
Surveys and Questionnaires

Associated data

ClinicalTrials.gov/NCT01538550