title: Psychological effects of colorectal cancer screening: Participantsvsindividuals not invited.
abstract: OBJECTIVE
  To investigate the possible long-term psychological harm of participating in colorectal cancer (CRC) screening in Norway.
  
  
  METHODS
  In a prospective, randomized trial, 14294 participants (aged 50-74 years) were invited to either flexible sigmoidoscopy (FS) screening, or a faecal immunochemical test (FIT) (1:1). In total, 4422 screening participants (32%) completed the questionnaire, which consisted of the Hospital Anxiety and Depression Scale and the SF-12, a generic health-related quality of life (HRQOL) measurement, when invited to screening and one year after the invitation. A control group of 7650 individuals was invited to complete the questionnaire only, at baseline and one year after, and 1911 (25%) completed the questionnaires.
  
  
  RESULTS
  Receiving a positive or negative screening result and participating in the two different screening modalities did not cause clinically relevant mean changes in anxiety, depression or HRQOL after one year. FS screening, but not FIT, was associated with an increased probability of being an anxiety case (score ≥ 8) at the one-year follow-up (5.6% of FS participants transitioned from being not anxious to anxious, while 3.0% experienced the reverse). This increase was moderately significantly different from the changes in the control group (in which the corresponding numbers were 4.8% and 4.5%, respectively),P= 0.06.
  
  
  CONCLUSIONS
  Most individuals do not experience psychological effects of CRC screening participation after one year, while FS participation is associated with increased anxiety for a smaller group.
authors.affiliation: Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Kirkøen
authors.affiliation: Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
authors.forename: Paula
authors.initials: P
authors.lastname: Berstad
authors.affiliation: Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Botteri
authors.affiliation: Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
authors.forename: Linn
authors.initials: L
authors.lastname: Bernklev
authors.affiliation: Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
authors.forename: Badboni
authors.initials: B
authors.lastname: El-Safadi
authors.affiliation: Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Hoff
authors.affiliation: Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: de Lange
authors.affiliation: Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
authors.forename: Tomm
authors.initials: T
authors.lastname: Bernklev
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D009780:Occult Blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012812:Sigmoidoscopy / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Anxiety; Colorectal cancer screening; Control group; Fecal immunochemical test; Flexible sigmoidoscopy; Health-related quality of life