Long-term psychosocial outcomes of low-dose CT screening: results of the UK Lung Cancer Screening randomised controlled trial
Open Access
- 28 July 2016
- Vol. 71 (11), 996-1005
- https://doi.org/10.1136/thoraxjnl-2016-208283
Abstract
Background The UK Lung Cancer Screening (UKLS) trial is a randomised pilot trial of low-dose CT (LDCT) screening for individuals at high risk of lung cancer. We assessed the long-term psychosocial impact on individuals participating in the UKLS trial. Methods A random sample of individuals aged 50–75 years was contacted via primary care. High-risk individuals who completed T0 questionnaires (baseline) were randomised to LDCT screening (intervention) or usual care (no screening control). T1 questionnaires were sent 2 weeks after baseline scan results or control assignment. T2 questionnaires were sent up to 2 years after recruitment. Measures included cancer distress, anxiety, depression and decision satisfaction. Results A total of 4037 high-risk individuals were randomised and they completed T0 questionnaires (n=2018 intervention, n=2019 control). Cancer distress was higher at T1 in intervention arm participants who received positive screening results (p≤0.001), but not at T2 (p=0.04). T2 anxiety (p≤0.001) and depression (p≤0.01) were higher in the control arm, but the absolute differences were small and not clinically relevant. At both time points, fewer control than screened participants were satisfied with their decision to participate in UKLS (p≤0.001). Regardless of trial allocation, cancer distress was higher in women (p≤0.01), participants aged ≤65 years (p≤0.001), current smokers (p≤0.001), those with lung cancer experience (p≤0.001) and those recruited from the Liverpool area (p≤0.001). Conclusion Lung cancer screening using LDCT appears to have no clinically significant long-term psychosocial impact on high-risk participants. Strategies for engaging and supporting underserved groups are the key to implement routine lung cancer screening in the UK. Trial registration number ISRCTN 78513845; results.Funding Information
- National Institute for Health Research
This publication has 31 references indexed in Scilit:
- UK Lung Cancer RCT Pilot Screening Trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screeningThorax, 2015
- Smoking is associated with pessimistic and avoidant beliefs about cancer: results from the International Cancer Benchmarking PartnershipBritish Journal of Cancer, 2015
- Impact of lung cancer screening results on participant health‐related quality of life and state anxiety in the National Lung Screening TrialCancer, 2014
- Psychosocial consequences of allocation to lung cancer screening: a randomised controlled trialBMJ Open, 2012
- Inequalities in participation in an organized national colorectal cancer screening programme: results from the first 2.6 million invitations in EnglandInternational Journal of Epidemiology, 2011
- Review of inverse probability weighting for dealing with missing dataStatistical Methods in Medical Research, 2011
- Long-term effects of lung cancer computed tomography screening on health-related quality of life: the NELSON trialEuropean Respiratory Journal, 2010
- Short-term health-related quality of life consequences in a lung cancer CT screening trial (NELSON)British Journal of Cancer, 2009
- Diagnosed with breast cancer while on a family history screening programme: an exploratory qualitative studyEuropean Journal of Cancer Care, 2008
- Participation in Cancer Clinical TrialsJAMA, 2004