Psychological consequences of cancer screening in HIV

There is a growing awareness of the increase in non-AIDS-defining cancers (NADC) in the HIV-infected population. Cancer screening is one means of reducing morbidity and mortality, but such screening may have psychological consequences across those with high and low-risk results, such as increased anxiety, worry and potential behavior change like increased self-examination or medical follow-up. This review examines the literature on psychological consequences of screening for NADC in HIV-infected populations.

Anal cancer is the only cancer type in which the psychological consequence of screening has been investigated in HIV-infected populations. Screening increases worry about anal cancer, particularly in those who are younger, have higher baseline anxiety or more symptoms. Participants with low-risk results show unrealistic optimism; this is a potential concern as it may lead to unrealistic beliefs about future risk, the need for healthy behaviors or follow-up screening. The lack of standardized screening protocols and programs makes assessing psychological consequences difficult.

More research is needed to determine if HIV populations differ from general population studies. Increased health promotion or symptom awareness is important for NADC with no standardized screening. Screening programs need to be aware of the potential for increased anxiety and worry and provide support as needed.