Short-term health-related quality of life consequences in a lung cancer CT screening trial (NELSON).
BACKGROUND
In lung cancer CT screening, participants often have an indeterminate screening result at baseline requiring a follow-up CT. In subjects with either an indeterminate or a negative result after screening, we investigated whether health-related quality of life (HRQoL) changed over time and differed between groups in the short term.


METHODS
A total of 733 participants in the NELSON trial received four questionnaires: T0, before randomisation; T1, 1 week before the baseline screening; T2, 1 day after the screening; and T3, 2 months after the screening results but before the 3-month follow-up CT. HRQoL was measured as generic HRQoL (the 12-item Short Form, SF-12; the EuroQol questionnaire, EQ-5D), anxiety (the Spielberger State-Trait Anxiety Inventory, STAI-6), and lung-cancer-specific distress (the Impact of Event Scale, IES). For analyses, repeated-measures analysis of variance was used, adjusted for covariates.


RESULTS
Response to each questionnaire was 88% or higher. Scores on SF-12, EQ-5D, and STAI-6 showed no clinically relevant changes over time. At T3, IES scores that were clinically relevant increased after an indeterminate result, whereas these scores showed a significant decrease after a negative result. At T3, differences in IES scores between the two baseline result groups were both significant and clinically relevant (P<0.01).


CONCLUSIONS
This longitudinal study among participants of a lung cancer screening programme showed that in the short term recipients of an indeterminate result experienced increased lung-cancer-specific distress, whereas the HRQoL changes after a negative baseline screening result may be interpreted as a relief.
van den Bergh
K A M
KA
Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, The Netherlands. k.vandenbergh@erasmusmc.nl
Essink-Bot
M L
ML
Borsboom
G J J M
GJ
Th Scholten
E
E
Prokop
M
M
de Koning
H J
HJ
van Klaveren
R J
RJ
D000368:Aged; D001530:Belgium; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D012907:Smoking / Q000453:epidemiology; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000523:psychology*; D035501:Uncertainty