title: CT-Screening for lung cancer does not increase the use of anxiolytic or antidepressant medication.
abstract: BACKGROUND
  CT screening for lung cancer has recently been shown to reduce lung cancer mortality, but screening may have adverse mental health effects. We calculated risk ratios for prescription of anti-depressive (AD) or anxiolytic (AX) medication redeemed at Danish pharmacies for participants in The Danish Lung Cancer Screening Trial (DLCST).
  
  
  METHODS
  The DLCST was a randomized clinical trial which comprised 4,104 former or present smokers who were randomized from 12 May 2004 to 20 June 2006 to either CT scan of the chest, lung-function test and filling in questionnaires annually for five years in the period 1 April 2006-31 March 2010 (n = 2,052), or to a control group (n = 2,052) receiving similar procedures except CT scan. We used CT scan intervention group versus control group status as exposure. The follow-up period for use of AD or AX was three years. Baseline data on civil status, socioeconomic status, and co-morbidity as well as outcome data on AD and AX were obtained by linkage to national registries.
  
  
  RESULTS
  The intervention and the control groups did not differ by age, gender, civil status, socio-economic position, co-morbidity index or former use of AD or AX. The adjusted risk ratio for at least one recipe of AD or AX in the CT intervention group during follow-up was not increased when adjusting for previous use of AD or AX, HR 1.00, 95 % CI (0.90-1.12). Similar results were seen when excluding subjects using AD or AX in a four-month or two-year period before baseline, when analyzing AD and AX separately, or requiring at least two recipes.
  
  
  CONCLUSIONS
  We found no indications that participation in a lung cancer CT-screening program increases the risk of specific adverse mental health outcomes.
  
  
  BACKGROUND
  Clinical Trials.gov Protocol Registration System (NCT00496977).
authors.affiliation: Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. Linda.Kaerlev@ouh.regionsyddanmark.dk
authors.forename: Linda
authors.initials: L
authors.lastname: Kaerlev
authors.forename: Maria
authors.initials: M
authors.lastname: Iachina
authors.forename: Jesper Holst
authors.initials: JH
authors.lastname: Pedersen
authors.forename: Anders
authors.initials: A
authors.lastname: Green
authors.forename: Bente Mertz
authors.initials: BM
authors.lastname: Nørgård
mesh_terms: D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy; D004363:Drug Utilization; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D012306:Risk; D014057:Tomography, X-Ray Computed
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents