Predictors for psychosocial consequences of screening for liver diseases: A data-driven approach

Medical screening is employed to detect early signs of diseases in asymptomatic populations, potentially improving patient outcomes through early intervention. However, the psychosocial impact of screenings remains a field of discussion. Inconsistent findings from studies, mainly originally from cancer research, are not easily transferable to the context of liver screening. This study aimed to identify predictors of psychosocial consequences in asymptomatic adults screened for early-stage liver cirrhosis, thereby contributing to the current knowledge on screening impact.

We analyzed data from 487 participants who underwent a systematic liver disease screening in Germany from January 2018 to February 2021. The screening involved blood tests, advanced diagnostics, and potentially, liver biopsies. We used bootstrapped LASSO regression with 10-fold validation to evaluate the influence of various predictors on psychosocial outcomes measured by the Psychological Consequences of Screening Questionnaire (PCQ).

The results show that severity of comorbidities (beta =  0.44-2.72), subjective social status (beta =  -0.30--0.86), and social support (beta =  -0.33--0.98) were consistent predictors across all psychosocial outcome measures by not covering zero in the confidence intervals. Older age (beta =  -0.03--0.08), the existence of a steady partnership (beta =  -1.08--0.48) and higher health literacy regarding the application of medical information (beta =  0.33-0.48) were associated with less psychosocial dysfunction, indicating their protective roles to prevent psychosocial burden of screening.

The study underscores the importance of considering individual patient characteristics in predicting psychosocial consequences of medical screening. Medical practitioners should consider personalized communication strategies taking into account the individual context of patients. The protective role of social support and stable personal relationships suggests that integrating psychosocial support services within screening programs could mitigate negative outcomes. Furthermore, increasing patient health literacy might help to demystify the screening process and can reduce psychosocial burden even if patients come from a segment of lower subjective social status.