title: Factors associated with cancer distress in the Asbestos Post-Exposure Survey (APEXS).
abstract: OBJECTIVE
  CT-scan screening programs for lung cancer detection have been proposed in high-risk subjects, and more recently in former asbestos-exposed subjects. However, to date no data are available on psychological impact of such programs. The aim of this study is to examine the risk factors of psychological distress at baseline of a CT-scan screening program among asbestos-exposed subjects.
  
  
  METHODS
  The Asbestos Post-Exposure Survey (APEXS) was carried out in France between October 2003 and December 2005 in order to screen asbestos-related diseases by CT-scan. Volunteers underwent self-administered questionnaires including an asbestos exposure assessment and, for a large sub-sample, a validated psychological distress scale. Non-exposed subjects were used as reference group.
  
  
  RESULTS
  At baseline, a significant higher level of distress was observed in exposed subjects (n = 3,122) relative to the reference group (n = 486) after adjustment on age, sex, and tobacco status. This distress is associated independently with the self-perception of (i) intensity of asbestos exposure and (ii) the risk of current or future disease related to the asbestos exposure. The perception of the cancer risk related to asbestos seems to play a fundamental role in this psychological distress.
  
  
  CONCLUSIONS
  In this study, asbestos-exposed subjects experienced a higher significant cancer distress than previously described in literature. These findings may be of potential public health importance. First, the impact of such occupational exposures on quality of life of patients who suffer from cancer related to these exposures has to be appraised. Secondly, the assessment of psychological impact of CT-scan screening programs among asbestos-exposed subjects is also required.
authors.affiliation: EA 2304 Centre Georges Devereux, Saint-Denis Cedex, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Maurel
authors.forename: Audrey
authors.initials: A
authors.lastname: Stoufflet
authors.forename: Laetitia
authors.initials: L
authors.lastname: Thorel
authors.forename: Veronique
authors.initials: V
authors.lastname: Berna
authors.forename: Antoine
authors.initials: A
authors.lastname: Gislard
authors.forename: Marc
authors.initials: M
authors.lastname: Letourneux
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Pairon
authors.forename: Christophe
authors.initials: C
authors.lastname: Paris
mesh_terms: D005260:Female; D005602:France; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000523:psychology*; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging / Q000523:psychology*; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000523:psychology*