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Anxiety, Fear of Cancer, and Perceived Risk of Cancer following Lung Cancer Screening

Department of Epidemiology and Public Health and Sylvester Comprehensive Cancer Center, University of Miami, mbyrne2{at}med.miami.edu

Joel Weissfeld, PhD

Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania

Mark S. Roberts, MD, MPP

Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

Background. Lung cancer screening can result in a high rate of indeterminate findings and has not yet been proven to be efficacious in reducing mortality. To date, the psychological consequences of receiving an indeterminate screening result are not known. Methods. Four hundred individuals were recruited into this study. Participants completed 4 surveys: baseline, after lung screening results were known, and at 6 and 12 mo after screening. Demographics, state/trait anxiety, fear of cancer, and perceived risk of lung cancer were measured. Mixed-model regressions were used to determine whether the levels and time trends of outcome variables were different among individuals with different screening outcomes. Results. An indeterminate screening result increased state anxiety of participants, although anxiety then decreased over time. The objective risk of cancer is lower for individuals with an indeterminate screen than their initial perceived risk, and screening did not change their perceived risk of cancer. Those with a suspicious screening result had increased perceived risk of cancer and fear of cancer after screening, and these effects also diminished over time. Individuals with a negative screen had a temporary reduction in perceived risk of cancer. Conclu sions. Individuals who are screened for lung cancer and receive an indeterminate or suspicious screening result have some negative psychological effects from being screened. The results suggest that individuals who are considering screening should be fully informed of the risk of negative psychosocial consequences and that individuals who have been screened should receive clear and detailed information on interpreting screening results.

Key Words: lung cancer screening • decision making • consequences • quality of life.

This version was published on November 1, 2008

Medical Decision Making, Vol. 28, No. 6, 917-925 (2008)
DOI: 10.1177/0272989X08322013


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