Psychological impact of lung cancer screening using a novel antibody blood test followed by imaging: the ECLS randomised controlled trial

Hancox, J.; Ayling, K.; Bedford, L.; Vedhara, K.; Robertson, J. F. R.; Young, B.; das Nair, R.; Sullivan, F. M.; Schembri, S.; Mair, F. S.; Littleford, R.; Kendrick., D.

Abstract

Background: The Early CDT®-Lung antibody blood test plus serial CT-scans for test-positives reduces late-stage lung cancer presentation. This study assessed psychological outcomes of this approach.

Methods: Randomised controlled trial (n=12,208) comparing psychological outcomes 1-12 months post-recruitment in a subsample (n=1032) of test-positive (TPG), test-negative (TNG) and control groups (CG).

Results: Compared to TNG, TPG had lower positive affect (Difference between means (DBM), 3-months (3m):-1.49 (-2.65, - 0.33)), greater impact of worries (DBM 1m:0.26 (0.05, 0.47); 3m:0.28 (0.07, 0.50)), screening distress (DBM 1m:3.59 (2.28, 4.90); 3m:2.29 (0.97, 3.61); 6m:1.94 (0.61, 3.27)) worry about tests (OR 1m:5.79 (2.66, 12.63) and more frequent lung cancer worry (Odds ratio (OR) 1m:2.52 (1.31, 4.83); 3m:2.43 (1.26, 4.68); 6m:2.87 (1.48, 5.60)).

Compared to CG, TPG had greater worry about tests (OR 1m:3.40 (1.69, 6.84)). TNG had lower negative affect (log-transformed DBM 3m:-0.08 (-0.13, -0.02)), higher positive affect (DBM 1m:1.52 (0.43, 2.61); 3m:1.43 (0.33, 2.53); 6m:1.27 (0.17, 2.37)), less impact of worries (DBM 3m:-0.27 (-0.48, -0.07)) and less frequent lung cancer worry (OR 3m:0.49 (0.26, 0.92)).

Conclusions: Negative psychological effects in TPG and positive effects in TNG were short-lived and most differences were small.

Citation

Hancox, J., Ayling, K., Bedford, L., Vedhara, K., Robertson, J. F. R., Young, B., …Kendrick., D. (2023). Psychological impact of lung cancer screening using a novel antibody blood test followed by imaging: the ECLS randomised controlled trial. Journal of Public Health, 45(2), e275–e284. https://doi.org/10.1093/pubmed/fdac032

• Journal Article Type: Article
• Acceptance Date: Jan 30, 2022
• Online Publication Date: Mar 14, 2022
• Publication Date: 2023-06
• Deposit Date: Feb 22, 2022
• Publicly Available Date: Mar 15, 2023
• Journal: Journal of Public Health
• Print ISSN: 1741-3842
• Electronic ISSN: 1741-3850
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 45
• Issue: 2
• Pages: e275–e284
• DOI: https://doi.org/10.1093/pubmed/fdac032
• Keywords: screening, early detection of cancer, lung neoplasms, psychology, behavioural medicine
• Public URL: https://nottingham-repository.worktribe.com/output/7503803
• Publisher URL: https://academic.oup.com/jpubhealth/article/45/2/e275/6548102