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Do no harm: no psychological harm from colorectal cancer screening
Benedicte Kirkøen1,2, Paula Berstad1,3, Edoardo Botteri1,4
1Department of Colorectal Cancer Screening, Cancer Registry of Norway, P.O. box 5313 Majorstuen, 0304 Oslo, Norway.
British Journal of Cancer
|February 12, 2016
Summary
Colorectal cancer (CRC) screening participation, including flexible sigmoidoscopy (FS) and faecal immunochemical test (FIT), did not cause clinically relevant psychological harm. Negative screening results even showed some psychological benefits.
Area of Science:
- Public Health
- Gastroenterology
- Psychology
Background:
- Concerns exist regarding potential psychological distress from cancer screening participation potentially outweighing mortality benefits.
- A colorectal cancer (CRC) screening pilot in Norway investigated the psychological impact on participants.
Purpose of the Study:
- To assess the psychological harm associated with participation in a colorectal cancer (CRC) screening pilot program.
- To evaluate the psychological effects of flexible sigmoidoscopy (FS) and faecal immunochemical test (FIT) screening methods.
Main Methods:
- A prospective, randomized trial involving 3,213 participants (aged 50-74) allocated to flexible sigmoidoscopy (FS), faecal immunochemical test (FIT), or no screening.
- Participants completed the Hospital Anxiety and Depression Scale and SF-12 health-related quality of life (HRQOL) questionnaires.
- A control group (2,618 participants) completed questionnaires without undergoing screening.
Main Results:
- Positive CRC screening results did not lead to increased anxiety, depression, or decreased HRQOL.
- Participants with negative screening results reported decreased anxiety and improved HRQOL, though not clinically significant.
- No clinically relevant psychological harm was observed in participants undergoing FS or FIT screening.
Conclusions:
- Participation in CRC screening (FS or FIT) does not result in clinically relevant psychological harm in the Norwegian population.
- The study provides evidence that CRC screening is psychologically safe, with potential minor benefits from negative results.
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