新型抗体血液检测联合影像学用于肺癌筛查的心理影响：ECLS 随机对照试验。
Psychological impact of lung cancer screening using a novel antibody blood test followed by imaging: the ECLS randomized controlled trial.
机构信息
Centre for Academic Primary Care, Lifespan and Population Health, School of Medicine, University of Nottingham, Applied Health Research Building, University Park, Nottingham, NG7 2RD.
Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.
出版信息
J Public Health (Oxf). 2023 Jun 14;45(2):e275-e284. doi: 10.1093/pubmed/fdac032.
BACKGROUND
The Early CDT®-Lung antibody blood test plus serial computed tomography scans for test-positives (TPGs) reduces late-stage lung cancer presentation. This study assessed the psychological outcomes of this approach.
METHODS
Randomized controlled trial (n = 12 208) comparing psychological outcomes 1-12 months post-recruitment in a subsample (n = 1032) of TPG, test-negative (TNG) and control groups (CG).
RESULTS
Compared to TNG, TPG had lower positive affect (difference between means (DBM), 3 months (3m: -1.49 (-2.65, - 0.33)), greater impact of worries (DBM 1m: 0.26 (0.05, 0.47); 3m: 0.28 (0.07, 0.50)), screening distress (DBM 1m: 3.59 (2.28, 4.90); 3m: 2.29 (0.97, 3.61); 6m: 1.94 (0.61, 3.27)), worry about tests (odds ratio (OR) 1m: 5.79 (2.66, 12.63) and more frequent lung cancer worry (OR 1m: 2.52 (1.31, 4.83); 3m: 2.43 (1.26, 4.68); 6m: 2.87 (1.48, 5.60)). Compared to CG, TPG had greater worry about tests (OR 1m: 3.40 (1.69, 6.84)). TNG had lower negative affect (log-transformed DBM 3m: -0.08 (-0.13, -0.02)), higher positive affect (DBM 1m: 1.52 (0.43, 2.61); 3m: 1.43 (0.33, 2.53); 6m: 1.27 (0.17, 2.37)), less impact of worries (DBM 3m: -0.27 (-0.48, -0.07)) and less-frequent lung cancer worry (OR 3m: 0.49 (0.26, 0.92)).
CONCLUSIONS
Negative psychological effects in TPG and positive effects in TNG were short-lived and most differences were small.
背景
早期 CDT®-Lung 抗体血液检测联合对阳性检测结果（TPG）的连续计算机断层扫描可降低晚期肺癌的检出率。本研究评估了这种方法的心理结果。
方法
对 TPG、阴性检测结果（TNG）和对照组（CG）亚组（n=1032）中招募后 1-12 个月的心理结果进行随机对照试验（n=12208）。
结果
与 TNG 相比，TPG 的积极影响较低（均值差值，3 个月：-1.49（-2.65，-0.33）），担忧的影响更大（1 个月：0.26（0.05，0.47）；3 个月：0.28（0.07，0.50）），筛查困扰（1 个月：3.59（2.28，4.90）；3 个月：2.29（0.97，3.61）；6 个月：1.94（0.61，3.27）），对测试的担忧（1 个月：OR 5.79（2.66，12.63）），且更频繁地担心肺癌（1 个月：OR 2.52（1.31，4.83）；3 个月：OR 2.43（1.26，4.68）；6 个月：OR 2.87（1.48，5.60））。与 CG 相比，TPG 对测试的担忧更大（1 个月：OR 3.40（1.69，6.84））。TNG 的消极影响较低（log 转换后 3 个月：-0.08（-0.13，-0.02）），积极影响较高（1 个月：1.52（0.43，2.61）；3 个月：1.43（0.33，2.53）；6 个月：1.27（0.17，2.37）），担忧的影响较小（3 个月：-0.27（-0.48，-0.07）），肺癌担忧频率较低（OR 3 个月：0.49（0.26，0.92））。
结论
TPG 的负性心理效应和 TNG 的正性心理效应都是短暂的，且大多数差异较小。
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