Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
Department of Surgery, Groene Hart ziekenhuis, Gouda, The Netherlands.
Psychooncology. 2020 Jun;29(6):1084-1091. doi: 10.1002/pon.5381. Epub 2020 Apr 14.
This study aimed to assess psychological functioning, quality of life, and regret about screening after a positive fecal immunochemical test (FIT) and subsequent colonoscopy, and to evaluate changes over time.
This is a prospective cohort study. Individuals aged 55 to 75 with a positive FIT that were referred for colonoscopy between July 2017 and November 2018, were invited to complete questionnaires related to psychological distress and health-related quality of life at three predefined time points: before colonoscopy, after histopathology result notification, and after 6 months. Four questionnaires were used: the Psychological Consequences Questionnaire (PCQ), the six-item Cancer Worry Scale (CWS), the Decision Regret Scale (DRS), and the 36-item Short-Form (SF-36).
A total of 1066 participants out of 2151 eligible individuals were included. Patients with cancer showed a significant increase in psychological dysfunction (P = .01) and cancer worry (P = .008) after colonoscopy result notification, and a decline to pre-colonoscopy measurements after 6 months. In the no-cancer groups, psychological dysfunction and cancer worry significantly decreased over time (P < .05) but there was no ongoing decline. After 6 months, 17% of participants with no cancer experienced high level of cancer worry (CWS ≥ 10). Yet, only 5% reported high level of regret about screening participation (DRS > 25). A good global quality of life was reported in participants with no cancer.
Some psychological distress remains up to 6 months after colonoscopy in participants who tested false-positive in the Dutch bowel cancer screening program.
本研究旨在评估粪便免疫化学检测（FIT）阳性后行结肠镜检查的人群的心理功能、生活质量和对筛查的后悔程度，并评估其随时间的变化。
这是一项前瞻性队列研究。2017 年 7 月至 2018 年 11 月期间，对接受结肠镜检查的年龄在 55 至 75 岁之间、FIT 阳性的个体进行前瞻性队列研究，邀请他们在三个预先设定的时间点（结肠镜检查前、组织病理学结果通知后和 6 个月后）完成与心理困扰和健康相关生活质量相关的问卷。使用了四个问卷：心理后果问卷（PCQ）、六项目癌症担忧量表（CWS）、决策后悔量表（DRS）和 36 项简明健康调查问卷（SF-36）。
在 2151 名符合条件的个体中，共有 1066 名参与者被纳入。在结肠镜检查结果通知后，患有癌症的患者表现出明显的心理功能障碍（P =.01）和癌症担忧（P =.008）增加，6 个月后降至结肠镜检查前的测量值。在无癌症组中，心理功能障碍和癌症担忧随时间显著下降（P <.05），但没有持续下降。6 个月后，17%的无癌症参与者出现高水平的癌症担忧（CWS≥10）。然而，只有 5%的人报告对筛查参与有高度的后悔（DRS>25）。无癌症参与者报告的总体生活质量良好。
在荷兰结直肠癌筛查项目中，FIT 假阳性的参与者在结肠镜检查后 6 个月内仍存在一些心理困扰。
