title: FIT false-positives in colorectal cancer screening experience psychological distress up to 6 weeks after colonoscopy.
abstract: OBJECTIVE
  Screening programs for colorectal cancer aim at reducing cancer mortality. We assessed psychological effects of being invited to an immunochemical fecal test (FIT)-based screening program.
  
  
  METHODS
  Asymptomatic persons aged 50-74 years were invited to a Dutch screening pilot. The Psychological Consequences Questionnaire (PCQ) was used to measure the psychological effects of screening. Screen positives had two additional measurements: before undergoing the colonoscopy and 4 weeks after receiving the colonoscopy findings.
  
  
  RESULTS
  A number of 3,828 invitees (46 % male, mean age 60 years) completed the first PCQ. FIT positives had a higher mean total PCQ score (8.32, SD 8.84; score range 0-36) than those who declined participation (3.72, SD 6.30); participants still waiting for their FIT result had a mean score of 2.74 (SD 5.11), and those with a negative FIT result had the lowest score (2.06, SD 4.43) (p < 0.001). In the 373 FIT positives who underwent colonoscopy, 195 completed the pre-colonoscopy questionnaire and 253, the post-colonoscopy questionnaire. Mean total, physical, and social PCQ scores had decreased significantly between the first questionnaire and the pre-colonoscopy one, but scores on the emotional subscale did not. In false-positives, mean total, physical, and emotional PCQ scores decreased significantly, while in true-positives, a significant decrease in mean emotional PCQ score was observed.
  
  
  CONCLUSIONS
  Psychological consequences for invitees to a Dutch FIT-based colorectal cancer screening pilot differ, depending on timing and FIT result. FIT positives are more distressed than FIT negatives. FIT positives still experience psychological distress 6 weeks after a normal colonoscopy.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Denters
authors.forename: M
authors.initials: M
authors.lastname: Deutekom
authors.forename: M L
authors.initials: ML
authors.lastname: Essink-Bot
authors.forename: P M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: P
authors.initials: P
authors.lastname: Fockens
authors.forename: E
authors.initials: E
authors.lastname: Dekker
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000523:psychology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology; D004644:Emotions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires