title: Do no harm: no psychological harm from colorectal cancer screening.
abstract: BACKGROUND
  Participation in cancer screening programmes might cause worries in the population outweighting the benefits of reduced mortality. The present study aimed to investigate possible psychological harm of participation in a colorectal cancer (CRC) screening pilot in Norway.
  
  
  METHODS
  In a prospective, randomised trial participants (aged 50-74 years) were invited to either flexible sigmoidoscopy (FS) screening, faecal immunochemical test (FIT), or no screening (the control group; 1 : 1: 1). Three thousand two hundred and thirteen screening participants (42% of screened individuals) completed the Hospital Anxiety and Depression Scale questionnaire as well as the SF-12-a health-related quality of life (HRQOL) questionnaire when invited to screening and when receiving the screening result. A control group was invited to complete the questionnaires only. Two thousand six hundred and eighteen control participants (35% of invited individuals) completed the questionnaire.
  
  
  RESULTS
  A positive screening result did not increase participants' level of anxiety or depression, or decrease participants' level of HRQOL. Participants who received a negative result reported decreased anxiety and improvement on some HRQOL dimensions. However, no change was considered to be of clinical relevance.
  
  
  CONCLUSIONS
  The current study showed no clinically relevant psychological harm of receiving a positive CRC screening result or of participating in FS or FIT screening, in a Norwegian population.
authors: Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.|Institute of Clinical Medicine, University of Oslo, P.O. box 1171 Blindern, 0318 Oslo, Norway.
authors: Benedicte
authors: B
authors: Kirkøen
authors: Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.|Department of Research and Development, Telemark Hospital Trust, 3710 Skien, Norway.
authors: Paula
authors: P
authors: Berstad
authors: Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.|Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors: Edoardo
authors: E
authors: Botteri
authors: Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, P.O. box 800, 3004 Drammen, Norway.
authors: Tone Lise
authors: TL
authors: Åvitsland
authors: Department of Gastroenterology, Østfold Hospital Trust, P.O. box 300, 1714 Grålum, Norway.
authors: Alvilde Maria
authors: AM
authors: Ossum
authors: Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.|Department of Internal Medicine, Vestre Viken Hospital Trust, Bærum Hospital, P.O. box 800, 3004 Drammen, Norway.
authors: Thomas
authors: T
authors: de Lange
authors: Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.|Department of Research and Development, Telemark Hospital Trust, 3710 Skien, Norway.|Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, P.O. box 1089 Blindern, 0318 Oslo, Norway.
authors: Geir
authors: G
authors: Hoff
authors: Institute of Clinical Medicine, University of Oslo, P.O. box 1171 Blindern, 0318 Oslo, Norway.|Department of Research and Development, Telemark Hospital Trust, 3710 Skien, Norway.
authors: Tomm
authors: T
authors: Bernklev
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003863:Depression / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D009780:Occult Blood; D011788:Quality of Life; D012812:Sigmoidoscopy / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires