The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
BMJ Open. 2020 Jun 4;10(6):e034682. doi: 10.1136/bmjopen-2019-034682.
Lung cancer CT screening can reduce lung cancer mortality, but high false-positive rates may cause adverse psychosocial consequences. The aim was to analyse the psychosocial consequences of false-positive lung cancer CT screening using the lung cancer screening-specific questionnaire, Consequences of Screening in Lung Cancer (COS-LC).
This study was a matched cohort study, nested in the randomised Danish Lung Cancer Screening Trial (DLCST).
Our study included all 130 participants in the DLCST with positive CT results in screening rounds 2-5, who had completed the COS-LC questionnaire. Participants were split into a true-positive and a false-positive group and were then matched 1:2 with a control group (n=248) on sex, age (±3 years) and the time of screening for the positive CT groups or clinic visit for the control group. The true positives and false positives were also matched 1:2 with participants with negative CT screening results (n=252).
Primary outcomes were psychosocial consequences measured at five time points.
False positives experienced significantly more negative psychosocial consequences in seven outcomes at 1 week and in three outcomes at 1 month compared with the control group and the true-negative group (mean ∆ score >0 and p<0.001). True positives experienced significantly more negative psychosocial consequences in one outcome at 1 week (mean ∆ score 2.86 (95% CI 1.01 to 4.70), p=0.0024) and in five outcomes at 1 month (mean ∆ score >0 and p<0.004) compared with the true-negative group and the control group. No long-term psychosocial consequences were identified either in false positives or true positives.
Receiving a false-positive result in lung cancer screening was associated with negative short-term psychosocial consequences. These findings contribute to the evidence on harms of screening and should be taken into account when considering implementation of lung cancer screening programmes.
NCT00496977.
肺癌 CT 筛查可降低肺癌死亡率，但高假阳性率可能导致不良的心理社会后果。本研究旨在通过肺癌筛查特异性问卷（肺癌筛查后果问卷，COS-LC）分析肺癌 CT 筛查假阳性的心理社会后果。
本研究是一项基于丹麦肺癌筛查试验（DLCST）的匹配队列研究。
本研究纳入 DLCST 中筛查轮 2-5 次 CT 结果阳性的 130 名参与者，他们完成了 COS-LC 问卷。参与者分为真阳性和假阳性组，然后根据性别、年龄（±3 岁）和阳性 CT 组的筛查时间或对照组的就诊时间，与对照组（n=248）进行 1:2 匹配。真阳性和假阳性组还与阴性 CT 筛查结果（n=252）的参与者进行 1:2 匹配。
主要结局是在五个时间点测量的心理社会后果。
与对照组和真阴性组相比，假阳性组在 1 周时有 7 个结局和在 1 个月时有 3 个结局出现明显更多的负性心理社会后果（平均 ∆ 评分>0，p<0.001）。真阳性组在 1 周时有 1 个结局（平均 ∆ 评分 2.86（95%CI 1.01 至 4.70），p=0.0024）和在 1 个月时有 5 个结局出现明显更多的负性心理社会后果（平均 ∆ 评分>0，p<0.004）。假阳性和真阳性组均未发现长期心理社会后果。
在肺癌筛查中获得假阳性结果与短期负性心理社会后果相关。这些发现有助于为筛查的危害提供证据，在考虑实施肺癌筛查项目时应予以考虑。
NCT00496977。
