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ABSTRACT: Objectives
The impact of lung cancer screening with low-dose chest CT (LDCT) on participants' anxiety levels and health-related quality of life (HRQoL) is an important consideration in the implementation of such programmes. We aimed to describe changes in anxiety and HRQoL in a high-risk Canadian cohort undergoing LDCT lung cancer screening.Methods
2537 subjects who had 2% or greater lung cancer risk over 6 years using a risk prediction tool were recruited from eight centres across Canada in the Pan-Canadian Early Detection of Lung Cancer Study (2008-2010). We compared HRQoL and anxiety levels before and after screening of 1237 participants with LDCT (excluding a subset of 1300 participants who also underwent autofluorescence bronchoscopy screening), as well as after investigations performed because of a positive screening examination. The 12-item short-form Physical and Mental Component Scales (SF-12), EQ-5D-3L scores and State Trait Anxiety Inventory-State anxiety were used at each assessment.Results
Overall, there were no clinically significant differences in HRQoL outcomes between baseline and each of the survey time points following initial screening. No mean change in anxiety in the overall cohort was noted following baseline LDCT, but more participants had clinically significant increase in anxiety versus decrease after baseline screening (increase >minimal clinically important difference (MCID) (n=180) vs decrease >MCID (n=50), p<0.001). This finding persisted but to a lesser degree at the 12 month time point (increase >MCID (n=146) vs decrease >MCID (n=87), p<0.001).Conclusions
CT screening for lung cancer has no major overall impact on HRQoL among participants, although a minority of participants (number-needed-to-harm=7 after baseline screening and 18 at 1 year) demonstrated clinically significant increased anxiety levels.Trialregistration number
NCT00751660; Results.
SUBMITTER: Taghizadeh N
PROVIDER: S-EPMC6340441 | biostudies-literature | 2019 Jan
REPOSITORIES: biostudies-literature
Taghizadeh Niloofar N Tremblay Alain A Cressman Sonya S Peacock Stuart S McWilliams Annette M AM MacEachern Paul P Johnston Michael R MR Goffin John J Goss Glen G Nicholas Garth G Martel Simon S Laberge Francis F Bhatia Rick R Liu Geoffrey G Schmidt Heidi H Atkar-Khattra Sukhinder S Tsao Ming-Sound MS Tammemagi Martin C MC Lam Stephen C SC
BMJ open 20190117 1
<h4>Objectives</h4>The impact of lung cancer screening with low-dose chest CT (LDCT) on participants' anxiety levels and health-related quality of life (HRQoL) is an important consideration in the implementation of such programmes. We aimed to describe changes in anxiety and HRQoL in a high-risk Canadian cohort undergoing LDCT lung cancer screening.<h4>Methods</h4>2537 subjects who had 2% or greater lung cancer risk over 6 years using a risk prediction tool were recruited from eight centres acro ...[more]