Lung cancer CT screening: psychological responses in the presence and absence of pulmonary nodules

Clark, Marcia E.; Bedford, Laura E.; Young, Ben; Robertson, John F.R.; das Nair, Roshan; Vedhara, Kavita; Littleford, Roberta; Sullivan, Frank M.; Mair, Frances S.; Schembri, Stuart; Rauchhaus, Petra; Kendrick, Denise

Abstract

Objectives: To determine the psychological response (thoughts, perceptions and affect) to a diagnosis of pulmonary nodules following a novel antibody blood test and computed tomography (CT) scans within a UK population.

Materials and methods: This study was nested within a randomised controlled trial of a blood test (Early CDT®-Lung test), followed by a chest x-ray and serial CT-scanning of those with a positive blood test for early detection of lung cancer (ECLS Study). Trial participants with a positive Early CDT®-Lung test were invited to participate (n=338) and those agreeing completed questionnaires assessing psychological outcomes at 1, 3 and 6 months following trial recruitment. Responses of individuals with pulmonary nodules on their first CT scan were compared to those without (classified as normal CT) at 3 and 6 months follow-up using random effects regression models to account for multiple observations per participant, with loge transformation of data where modelling assumptions were not met.

Results: There were no statistically significant differences between the nodule and normal CT groups in affect, lung cancer worry, health anxiety, illness perceptions, lung cancer risk perception or intrusive thoughts at 3 or 6 months post-recruitment. The nodule group had statistically significantly fewer avoidance symptoms compared to the normal CT group at 3 months (impact of events scale avoidance (IES-A) difference between means -1.99, 95%CI -4.18, 0.21) than at 6 months (IES-A difference between means 0.88, 95%CI -1.32, 3.08; p-value for change over time =0.003) with similar findings using loge transformed data.

Conclusion: A diagnosis of pulmonary nodules following an Early CDT®-Lung test and CT scan did not appear to result in adverse psychological responses compared to those with a normal CT scan.

Citation

Clark, M. E., Bedford, L. E., Young, B., Robertson, J. F., das Nair, R., Vedhara, K., …Kendrick, D. (2018). Lung cancer CT screening: psychological responses in the presence and absence of pulmonary nodules. Lung Cancer, 124, 160-167. https://doi.org/10.1016/j.lungcan.2018.08.001

• Journal Article Type: Article
• Acceptance Date: Aug 2, 2018
• Online Publication Date: Aug 3, 2018
• Publication Date: Oct 31, 2018
• Deposit Date: Aug 6, 2018
• Publicly Available Date: Aug 4, 2019
• Print ISSN: 0169-5002
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 124
• Pages: 160-167
• DOI: https://doi.org/10.1016/j.lungcan.2018.08.001
• Keywords: Pulmonary nodules; Lung cancer screening; Psychological impact
• Public URL: https://nottingham-repository.worktribe.com/output/952837
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0169500218305063