title: Long-term psychosocial outcomes of low-dose CT screening: results of the UK Lung Cancer Screening randomised controlled trial.
abstract: The UK Lung Cancer Screening (UKLS) trial is a randomised pilot trial of low-dose CT (LDCT) screening for individuals at high risk of lung cancer. We assessed the long-term psychosocial impact on individuals participating in the UKLS trial.
  
  
  
  A random sample of individuals aged 50-75 years was contacted via primary care. High-risk individuals who completed T0questionnaires (baseline) were randomised to LDCT screening (intervention) or usual care (no screening control). T1questionnaires were sent 2 weeks after baseline scan results or control assignment. T2questionnaires were sent up to 2 years after recruitment. Measures included cancer distress, anxiety, depression and decision satisfaction.
  
  
  
  A total of 4037 high-risk individuals were randomised and they completed T0questionnaires (n=2018 intervention, n=2019 control). Cancer distress was higher at T1in intervention arm participants who received positive screening results (p≤0.001), but not at T2(p=0.04). T2anxiety (p≤0.001) and depression (p≤0.01) were higher in the control arm, but the absolute differences were small and not clinically relevant. At both time points, fewer control than screened participants were satisfied with their decision to participate in UKLS (p≤0.001). Regardless of trial allocation, cancer distress was higher in women (p≤0.01), participants aged ≤65 years (p≤0.001), current smokers (p≤0.001), those with lung cancer experience (p≤0.001) and those recruited from the Liverpool area (p≤0.001).
  
  
  
  Lung cancer screening using LDCT appears to have no clinically significant long-term psychosocial impact on high-risk participants. Strategies for engaging and supporting underserved groups are the key to implement routine lung cancer screening in the UK.
  
  
  
  ISRCTN 78513845; results.
authors.affiliation: Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Brain
authors.affiliation: Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Kate J
authors.initials: KJ
authors.lastname: Lifford
authors.affiliation: Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Carter
authors.affiliation: Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Olivia
authors.initials: O
authors.lastname: Burke
authors.affiliation: Public Health England, Liverpool, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: McRonald
authors.affiliation: Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: Anand
authors.initials: A
authors.lastname: Devaraj
authors.affiliation: Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: David M
authors.initials: DM
authors.lastname: Hansell
authors.affiliation: Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK.
authors.forename: David
authors.initials: D
authors.lastname: Baldwin
authors.affiliation: Queen Mary University of London, London, UK.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Duffy
authors.affiliation: University of Liverpool, Liverpool, UK.
authors.forename: John K
authors.initials: JK
authors.lastname: Field
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000523:psychology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010865:Pilot Projects; D011829:Radiation Dosage; D018570:Risk Assessment; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000379:methods*; D006113:United Kingdom
keywords: Imaging/CT MRI etc; Lung Cancer; Psychology