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Lung Cancer. 2018 Oct;124:160-167. doi: 10.1016/j.lungcan.2018.08.001. Epub 2018 Aug 3.

Lung cancer CT screening: Psychological responses in the presence and absence of pulmonary nodules.

Author information

1
University of Nottingham, Division of Primary Care, United Kingdom.
2
University of Nottingham, Division of Medical Sciences and Graduate Entry Medicine, United Kingdom.
3
University of Nottingham, Institute of Mental Health, United Kingdom.
4
University of Dundee, Tayside Clinical Trials Unit, United Kingdom.
5
University of St Andrews, School of Medicine, United Kingdom.
6
University of Glasgow, General Practice and Primary Care, United Kingdom.
7
University of Dundee, Scottish Centre for Respiratory Research, United Kingdom.
8
University of Nottingham, Division of Primary Care, United Kingdom. Electronic address: denise.kendrick@nottingham.ac.uk.

Abstract

OBJECTIVES:

To determine the psychological response (thoughts, perceptions and affect) to a diagnosis of pulmonary nodules following a novel antibody blood test and computed tomography (CT) scans within a UK population.

MATERIALS AND METHODS:

This study was nested within a randomised controlled trial of a blood test (Early CDT®-Lung test), followed by a chest x-ray and serial CT-scanning of those with a positive blood test for early detection of lung cancer (ECLS Study). Trial participants with a positive Early CDT®-Lung test were invited to participate (n = 338) and those agreeing completed questionnaires assessing psychological outcomes at 1, 3 and 6 months following trial recruitment. Responses of individuals with pulmonary nodules on their first CT scan were compared to those without (classified as normal CT) at 3 and 6 months follow-up using random effects regression models to account for multiple observations per participant, with loge transformation of data where modelling assumptions were not met.

RESULTS:

There were no statistically significant differences between the nodule and normal CT groups in affect, lung cancer worry, health anxiety, illness perceptions, lung cancer risk perception or intrusive thoughts at 3 or 6 months post-recruitment. The nodule group had statistically significantly fewer avoidance symptoms compared to the normal CT group at 3 months (impact of events scale avoidance (IES-A) difference between means -1.99, 95%CI -4.18, 0.21) than at 6 months (IES-A difference between means 0.88, 95%CI -1.32, 3.08; p-value for change over time = 0.003) with similar findings using loge transformed data.

CONCLUSION:

A diagnosis of pulmonary nodules following an Early CDT®-Lung test and CT scan did not appear to result in adverse psychological responses compared to those with a normal CT scan.

KEYWORDS:

Lung cancer screening; Psychological impact; Pulmonary nodules

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