Rasmussen Jakob F, Siersma V, Pedersen J H, Brodersen J
The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark.
The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark.
Lung Cancer. 2015 Jan;87(1):65-72. doi: 10.1016/j.lungcan.2014.11.003. Epub 2014 Nov 20.
To measure the psychosocial consequences in the Danish lung cancer screening trial (DLCST) and compare those between the computed tomography (CT) group and the control group.
This study was a single centre randomised controlled trial with five annual screening rounds. Healthy current or former heavy smokers aged 50-70 years (men and women) were randomised 1:1 to a CT group and a control group. Heavy smokers were defined by having smoked ≥20 pack years and former smokers by being abstinent ≤10 years. Both groups were invited annually to the screening clinic to complete the validated lung-cancer-specific questionnaire consequences of screening lung cancer (COS-LC). The CT group was also offered a low dose CT scan of the lungs. The COS-LC measures nine scales with psychosocial properties: Anxiety, Behaviour, Dejection, Negative impact on sleep, Self-blame, Focus on Airway Symptoms, Stigmatisation, Introvert, and Harm of Smoking.
4104 participants were randomised to the DLCST and the COS-LC completion rates for the CT group and the control group were 95.5% and 73.6%, respectively. There was a significant increase in negative psychosocial consequences from baseline through rounds 2-5 for both the CT group and the control group (mean increase >0, p<.0001 for 3 of 4 possible scales). During rounds 2-5 the control group experienced significantly more negative psychosocial consequences in seven of nine scales compared with the CT group (mean Δ score >0 and p<.033).
Lung cancer CT-screening trials induced more negative psychosocial reactions in both the CT group and the control group compared with the baseline psychosocial profile. The CT group experienced less negative psychosocial consequences compared with the control group, which might be explained by reassurance among those with normal screening results.
ClinicalTrials.gov: NCT00496977.
评估丹麦肺癌筛查试验（DLCST）中的社会心理影响，并比较计算机断层扫描（CT）组和对照组之间的差异。
本研究为单中心随机对照试验，共进行了五轮年度筛查。年龄在50 - 70岁的健康现吸烟者或既往重度吸烟者（男性和女性）按1:1随机分为CT组和对照组。重度吸烟者定义为吸烟≥20包年，既往吸烟者定义为戒烟≤10年。两组每年均被邀请至筛查诊所，完成经过验证的肺癌筛查社会心理影响问卷（COS-LC）。CT组还接受了肺部低剂量CT扫描。COS-LC测量九个具有社会心理特征的量表：焦虑、行为、沮丧、对睡眠的负面影响、自责、关注气道症状、污名化、内向和吸烟危害。
4104名参与者被随机分配至DLCST，CT组和对照组的COS-LC完成率分别为95.5%和73.6%。从基线到第2 - 5轮，CT组和对照组的负面社会心理影响均显著增加（4个可能量表中的3个量表平均增加>0，p<0.0001）。在第2 - 5轮中，与CT组相比，对照组在九个量表中的七个量表上经历了更多的负面社会心理影响（平均差异得分>0且p<0.033）。
与基线社会心理状况相比，肺癌CT筛查试验在CT组和对照组中均引发了更多负面社会心理反应。与对照组相比，CT组经历的负面社会心理影响较少，这可能是由于筛查结果正常者得到了安慰。
ClinicalTrials.gov：NCT00496977。
