Worry associated with screening for colorectal carcinomas

We wanted to assess the worry created by a screening program for colorectal cancer with fecal occult blood testing.

Six thousand three hundred and sixty-six individuals (47% men; 53% women) were asked to what extent they were worried when they received an invitation letter including a Hemoccult II test (HII). The questionnaire was supplemented by a structured telephone interview of a selected number of individuals with different outcome of the HII.

Three thousand four hundred and eighty-six subjects performed the HII test, and 3548 (56%) answered the questionnaire. Eighty-four per cent (n = 2932) of the participants and 21% (n = 616) of the non-participants completed the questionnaire. Half of the participants (54%) were not worried at all, but 16%, more women than men, felt severe worry, which lasted less than 1 week in 59%. In 4.7% of the participants daily life was negatively influenced by the invitation letter. In the telephone interview 19% reported severe worry before they received the result of the first test, and in 5.8% daily life was negatively affected. The worry rate increased to 60% in the groups with an initial positive HII test, and in 15% daily life was negatively influenced. After the examination the worry decreased in most but was still pronounced in 10%. One year after the work-up 96% declared that they appreciated the study. Subjects with only elementary school education expressed more worry than those with a higher level of education (P < 0.05).

Severe worry in connection with the invitation was reported by a minority of the invited participants, more women than men. The worry increased among those who had a positive test but decreased after the examination. One year after the work-up most appreciated the study.