title: High affective risk perception is associated with more lung cancer-specific distress in CT screening for lung cancer.
abstract: Screening for cancer can cause distress. People who perceive their risk of cancer as high may be more vulnerable to distress. This study evaluated whether participants of a lung cancer Computed Tomography (CT) screening trial with a high affective risk perception of developing lung cancer had a higher level of lung cancer-specific distress during CT screening. Furthermore, we evaluated whether participants perceived their risk of developing lung cancer differently 6 months after screening compared with 1 day before screening. A total of 351 subsequent participants of the NELSON-trial (Dutch-Belgian randomized controlled trial for lung cancer screening in high-risk subjects), who were randomized to the screen arm, were asked to fill in questionnaires 1 day before and 6 months after screening. Lung cancer-specific distress (Impact of Event Scale (IES)), generic health-related quality of life (SF-12) and affective risk perception were assessed. One day before screening, the participants with a high affective risk perception (n=47/321, 14.6%) had significantly higher (i.e., worse) median IES scores than participants with a low affective risk perception (11.5 vs. 2.0, p<0.01). Although median IES scores were significantly lower 6 months after screening than 1 day before screening, participants with a high affective risk perception still showed significantly higher IES scores than participants with a low affective risk perception (6.5 vs. 1.0, p<0.01). Six months after screening, significantly less participants (10.5%) felt that their risk of developing lung cancer was high than 1 day before screening (14.5%) (p<0.01). Levels of distress were not severe, but were elevated compared to participants with a low affective risk perception, and therefore, attention for this group is recommended.
authors.affiliation: Department of Public Health, Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: Eveline M
authors.initials: EM
authors.lastname: Bunge
authors.forename: Karien A M
authors.initials: KA
authors.lastname: van den Bergh
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van Klaveren
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
mesh_terms: D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011788:Quality of Life; D012309:Risk-Taking; D012907:Smoking; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*