title: Psychological outcomes of familial ovarian cancer screening: no evidence of long-term harm.
abstract: OBJECTIVE
  Ovarian cancer screening for women at increased genetic risk in the UK involves 4-monthly CA125 tests and annual ultrasound, with further tests prompted by an abnormal result. The study evaluated the longer-term psychological and behavioural effects of frequent ovarian screening.
  
  
  METHODS
  Women completed T1 questionnaires before their first routine 4-monthly CA125 test, and T2 follow-up questionnaires one week after their result. Women with abnormal results completed a further questionnaire one week after return to routine screening (T3 primary end-point). T4 questionnaires were sent at nine months. Measures included cancer distress, general anxiety/depression, reassurance, and withdrawal from screening.
  
  
  RESULTS
  A total 1999 (62%) of 3224 women completed T1 questionnaires. T2 questionnaires were completed by 1384/1609 participants (86%): 1217 (89%) with normal results and 167/242 (69%) with abnormal results. T3 questionnaires were completed by 141/163 (87%) women, with 912/1173 (78%) completing T4 questionnaires. Analysis of covariance indicated that, compared to women with normal results, women with abnormal results reported moderate cancer distress (F = 27.47, p ≤ .001, η(2) = 0.02) one week after their abnormal result and were significantly more likely to withdraw from screening (OR = 4.38, p ≤ .001). These effects were not apparent at T3 or T4. The effect of screening result on general anxiety/depression or overall reassurance was not significant.
  
  
  CONCLUSIONS
  Women participating in frequent ovarian screening who are recalled for an abnormal result may experience transient cancer-specific distress, which may prompt reconsideration of risk management options. Health professionals and policy makers may be reassured that frequent familial ovarian screening does not cause sustained psychological harm.
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Neuadd Meirionnydd, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, UK. brainke@cardiff.ac.uk
authors.forename: Kate E
authors.initials: KE
authors.lastname: Brain
authors.forename: Kate J
authors.initials: KJ
authors.lastname: Lifford
authors.forename: Lindsay
authors.initials: L
authors.lastname: Fraser
authors.forename: Adam N
authors.initials: AN
authors.lastname: Rosenthal
authors.forename: Mark T
authors.initials: MT
authors.lastname: Rogers
authors.forename: Deborah
authors.initials: D
authors.lastname: Lancastle
authors.forename: Ceri
authors.initials: C
authors.lastname: Phelps
authors.forename: Eila K
authors.initials: EK
authors.lastname: Watson
authors.forename: Alison
authors.initials: A
authors.lastname: Clements
authors.forename: Usha
authors.initials: U
authors.lastname: Menon
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000523:psychology*; D013997:Time Factors