Kirkøen Benedicte, Berstad Paula, Botteri Edoardo, Åvitsland Tone Lise, Ossum Alvilde Maria, de Lange Thomas, Hoff Geir, Bernklev Tomm
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.
Br J Cancer. 2016 Mar 1;114(5):497-504. doi: 10.1038/bjc.2016.14. Epub 2016 Feb 11.
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.
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.
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.
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.
参与癌症筛查项目可能会在人群中引发担忧，这种担忧超过了降低死亡率所带来的益处。本研究旨在调查参与挪威一项结直肠癌（CRC）筛查试点可能造成的心理伤害。
在一项前瞻性随机试验中，邀请年龄在50 - 74岁的参与者接受乙状结肠镜检查（FS）筛查、粪便免疫化学检测（FIT）或不进行筛查（对照组；比例为1∶1∶1）。3213名筛查参与者（占筛查个体的42%）在被邀请参加筛查以及收到筛查结果时，完成了医院焦虑抑郁量表问卷以及SF - 12健康相关生活质量（HRQOL）问卷。对照组仅被邀请完成问卷。2618名对照参与者（占被邀请个体的35%）完成了问卷。
筛查结果呈阳性并未增加参与者的焦虑或抑郁水平，也未降低参与者的HRQOL水平。收到阴性结果的参与者报告焦虑有所减轻，并且在一些HRQOL维度上有所改善。然而，这些变化被认为无临床相关性。
当前研究表明，在挪威人群中，收到CRC筛查阳性结果或参与FS或FIT筛查均未造成具有临床相关性的心理伤害。
