title: Psychological impact of breast cancer screening in Japan.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the psychological impact of breast cancer screening by use of mammography and/or ultrasound, and to reveal factors related to psychological distress.
  
  
  METHODS
  Three hundred and twenty women were recalled to our hospital because of suspicious malignant findings from breast cancer screening between March and November 2012. They were asked to complete three questionnaires: the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression, the Brief Coping Orientations to Problems Experienced scale (Brief COPE) for coping styles, and an original questionnaire for personal information.
  
  
  RESULTS
  Complete data were available for 312 of 320 women (97.5 %). The median age was 45 years (range 23-73). The HADS revealed borderline or clinically significant anxiety for 70 % of the women. Family history of breast cancer, area of residence, number of times screened, number of recalls, and the period before the first visit were significantly related to psychological distress (p < 0.05). Brief COPE scores showed that self-blame, behavioral disengagement, self-distraction, use of emotional support, venting, denial, and less acceptance were related to increased anxiety.
  
  
  CONCLUSIONS
  Seventy percent of women who were recalled after breast cancer screening experienced psychological distress. Thus, negative psychological impact should be regarded as an adverse effect of breast cancer screening.
authors.affiliation: Department of Medical Oncology, St. Luke's International Hospital, Tokyo, Japan. atkitano@ncc.go.jp.|Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan. atkitano@ncc.go.jp.|Department of Pathology and Laboratory Medicine, Showa University of School of Medicine, Tokyo, Japan. atkitano@ncc.go.jp.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kitano
authors.affiliation: Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Hideko
authors.initials: H
authors.lastname: Yamauchi
authors.affiliation: Department of Psycho-oncology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hosaka
authors.affiliation: Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagata
authors.affiliation: Department of Nursing, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Hosokawa
authors.affiliation: Center of Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Ohde
authors.affiliation: Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Seigo
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Pathology and Laboratory Medicine, Showa University of School of Medicine, Tokyo, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Takimoto
authors.affiliation: Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-cho Chuo-ku, Tokyo, 104-8560, Japan. hirokots@luke.ac.jp.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tsunoda
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan; D008327:Mammography / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: Breast cancer; Breast screening; Psychological distress; Psychological impact