title: Impact of lung cancer screening results on participant health-related quality of life and state anxiety in the National Lung Screening Trial.
abstract: BACKGROUND
  Low-dose computed tomography (LDCT) lung screening has been associated with a 20% reduction in lung cancer mortality. A major barrier to the adoption of lung screening is the potential negative psychological impact of a false-positive (FP) screen, occurring in 20% to 50% of those screened. The objective of this study was to assess the impact of abnormal findings on health-related quality of life (HRQoL) and anxiety in the American College of Radiology (ACRIN)/National Lung Screening Trial (NLST).
  
  
  METHODS
  The NLST was a randomized screening trial comparing LDCT with chest X-ray screening (CXR). This study was part of the original protocol. A total of 2812 participants at 16 of 23 ACRIN sites who had baseline HRQoL assessments were asked to complete the Short Form-36 and the State Trait Anxiety Inventory (form Y-1) questionnaires to assess short-term (1 month) and long-term (6 months) effects of screening. FP were lung cancer-free at 1 year, and true-positives (TP) were not.
  
  
  RESULTS
  Of the total participants, 1024 (36.4%) participants were FP, 63 (2.2%) were TP, 344 (12.2%) had significant incidental findings (SIFs), and 1381 (49.1%) had negative screens. Participants had been randomized to LDCT (n = 1947) and CXR (n = 865). Short-term and long-term HRQoL and state anxiety did not differ across participants with FP, SIF, or negative screens. Short-term and long-term HRQoL were lower and anxiety was higher for TP participants compared to participants with FP, SIF, and negative screens.
  
  
  CONCLUSIONS
  In a large multicenter lung screening trial, participants receiving a false-positive or SIF screen result experienced no significant difference in HRQoL or state anxiety at 1 or at 6 months after screening relative to those receiving a negative result.
authors: Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island; Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.
authors: Ilana F
authors: IF
authors: Gareen
authors: Fenghai
authors: F
authors: Duan
authors: Erin M
authors: EM
authors: Greco
authors: Bradley S
authors: BS
authors: Snyder
authors: Phillip M
authors: PM
authors: Boiselle
authors: Elyse R
authors: ER
authors: Park
authors: Dennis
authors: D
authors: Fryback
authors: Constantine
authors: C
authors: Gatsonis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011788:Quality of Life; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: anxiety; clinical trials; lung cancer; quality of life; screening