Kirkøen Benedicte, Berstad Paula, Botteri Edoardo, Bernklev Linn, El-Safadi Badboni, Hoff Geir, de Lange Thomas, Bernklev Tomm
Benedicte Kirkøen, Paula Berstad, Edoardo Botteri, Geir Hoff, Thomas de Lange, Department of bowel cancer screening, Cancer Registry of Norway, Majorstuen, 0304 Oslo, Norway.
World J Gastroenterol. 2016 Nov 21;22(43):9631-9641. doi: 10.3748/wjg.v22.i43.9631.
To investigate the possible long-term psychological harm of participating in colorectal cancer (CRC) screening in Norway.
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.
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), = 0.06.
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.
调查在挪威参与结直肠癌（CRC）筛查可能产生的长期心理伤害。
在一项前瞻性随机试验中，14294名参与者（年龄在50 - 74岁之间）被邀请接受乙状结肠镜检查（FS）筛查或粪便免疫化学检测（FIT）（比例为1:1）。共有4422名筛查参与者（32%）在被邀请参加筛查时以及邀请后一年完成了问卷，问卷包括医院焦虑抑郁量表和SF - 12，这是一种通用的健康相关生活质量（HRQOL）测量工具。一个由7650人组成的对照组被邀请仅在基线时和一年后完成问卷，1911人（25%）完成了问卷。
在一年后，收到阳性或阴性筛查结果以及参与两种不同的筛查方式并未导致焦虑、抑郁或HRQOL出现具有临床意义的平均变化。在一年随访时，FS筛查（而非FIT）与成为焦虑症患者（得分≥8）的概率增加相关（5.6%的FS参与者从不焦虑转变为焦虑，而3.0%经历相反情况）。这一增加与对照组的变化（相应数字分别为4.8%和4.5%）有中度显著差异，P = 0.06。
大多数人在参与CRC筛查一年后未出现心理影响，而对于较小一部分群体，参与FS筛查与焦虑增加有关。
