van der Velde J L, Blanker M H, Stegmann M E, de Bock G H, Berger M Y, Berendsen A J
Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Eur J Cancer Care (Engl). 2017 May;26(3). doi: 10.1111/ecc.12709. Epub 2017 May 11.
Screening for colorectal cancer (CRC) has both advantages (e.g. reduction in morbidity and mortality) and disadvantages (e.g. false positives and distress). A systematic review was therefore performed to improve our understanding of how false-positive CRC screening results affect patients psychologically (and to make recommendations for primary care). The PubMed, Embase, PsychINFO, CINAHL and Cochrane databases were searched in October 2014 and supplemented in December 2016 to identify studies on the psychological impact of false-positive CRC screening. Original studies were eligible when they assessed psychological impact in a screening setting, provided they also included false-positive CRC screening results. Two authors independently assessed 2,367 available manuscripts and included seven. Heterogeneity in their outcome measures meant that data could not be pooled. Two studies showed that a false-positive CRC screening result caused some moderate psychological distress shortly before and after colonoscopy. The remaining five studies illustrated that the psychological distress of patients with true-positive and false-positive CRC screening results was comparable. We conclude that a false-positive CRC screening result may cause some moderate psychological distress, especially just before or after colonoscopy. We recommend that general practitioners mention this when discussing CRC screening with patients and monitor those with a false-positive outcome for psychological distress.
结直肠癌（CRC）筛查既有优点（如降低发病率和死亡率）也有缺点（如假阳性和困扰）。因此，进行了一项系统综述，以增进我们对结直肠癌筛查假阳性结果如何在心理上影响患者的理解（并为初级保健提供建议）。2014年10月检索了PubMed、Embase、PsychINFO、CINAHL和Cochrane数据库，并于2016年12月进行了补充，以确定关于结直肠癌筛查假阳性心理影响的研究。如果原始研究在筛查环境中评估心理影响，且还包括结直肠癌筛查假阳性结果，则符合纳入标准。两位作者独立评估了2367篇可用手稿，纳入了7篇。其结果测量的异质性意味着数据无法合并。两项研究表明，结直肠癌筛查假阳性结果在结肠镜检查前后不久会引起一些中度心理困扰。其余五项研究表明，结直肠癌筛查真阳性和假阳性结果患者的心理困扰相当。我们得出结论，结直肠癌筛查假阳性结果可能会引起一些中度心理困扰，尤其是在结肠镜检查之前或之后。我们建议全科医生在与患者讨论结直肠癌筛查时提及这一点，并监测假阳性结果患者的心理困扰情况。
