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Surveillance of indeterminate pulmonary nodules detected with CT in a Swedish population-based study (SCAPIS) : psychosocial consequences and impact on health-related quality of life-a multicentre prospective cross-sectional study

Andersson, Elisabeth ; Dai Ydrefelt, Ying ; Johannesson, Marit ; Lundbäck, Maria ; Mannila, Maria ; Persson, Margaretha LU orcid ; Swahn, Eva and Bolejko, Anetta LU (2021) In BMJ Open 11(9).
Abstract

OBJECTIVES: To investigate whether surveillance of pulmonary nodules detected with low-dose CT (LDCT) impacted health-related quality of life and psychosocial consequences in the Swedish population-based study, Swedish CArdioPulmonary bioImage Study (SCAPIS).

DESIGN: A prospective cross-sectional study.

SETTINGS AND PARTICIPANTS: This multicentre (five sites) observational study, which included a cohort from SCAPIS, consisted of 632 participants with indeterminate pulmonary nodules detected with LDCT. These participants continued surveillance for up to 36 months, during which lung cancer was not detected (surveillance group). Additionally, 972 participants with a negative pulmonary LDCT scan were included as a control group.... (More)

OBJECTIVES: To investigate whether surveillance of pulmonary nodules detected with low-dose CT (LDCT) impacted health-related quality of life and psychosocial consequences in the Swedish population-based study, Swedish CArdioPulmonary bioImage Study (SCAPIS).

DESIGN: A prospective cross-sectional study.

SETTINGS AND PARTICIPANTS: This multicentre (five sites) observational study, which included a cohort from SCAPIS, consisted of 632 participants with indeterminate pulmonary nodules detected with LDCT. These participants continued surveillance for up to 36 months, during which lung cancer was not detected (surveillance group). Additionally, 972 participants with a negative pulmonary LDCT scan were included as a control group. Matching criteria were LDCT date (±2 weeks), gender and site.

OUTCOME MEASURES: All participants completed a health-related quality of life questionnaire (RAND-36) and the Consequences of Screening (COS) questionnaire, an average of 3 years after LDCT was conducted at entry into SCAPIS.

RESULTS: Participants were 51-70 years old at study commencement. Overall, the two groups did not differ in demographic or psychosocial variables, smoking habits or pulmonary medical history. Individuals from countries other than Sweden and those with low socioeconomic status were less likely to participate (p<0.001). No effects on health-related quality of life were observed via RAND-36. In COS, the surveillance group demonstrated a higher OR for anxiety about lung cancer (OR 3.96, 95% CI 2.35 to 6.66, p<0.001), experiencing a sense of dejection (OR 1.35, 95% CI 1.06 to 1.72, p=0.015) and thoughts about existential values (OR 1.30, 95% CI 1.04 to 1.60, p=0.018).

CONCLUSIONS: Lung surveillance with LDCT contributed to significant experiences of sense of dejection, anxiety about lung cancer and development of thoughts about existential values among participants in the surveillance group compared with the controls. The risk of side effects should be communicated for informed decision-making about (non-)attendance in lung cancer screening.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMJ Open
volume
11
issue
9
article number
e048721
publisher
BMJ Publishing Group
external identifiers
  • scopus:85115398824
  • pmid:34535477
ISSN
2044-6055
DOI
10.1136/bmjopen-2021-048721
language
English
LU publication?
yes
id
34c5db22-0d92-42f5-9309-e0d57482436f
date added to LUP
2021-09-23 16:48:10
date last changed
2024-03-23 10:06:38
@article{34c5db22-0d92-42f5-9309-e0d57482436f,
  abstract     = {{<p>OBJECTIVES: To investigate whether surveillance of pulmonary nodules detected with low-dose CT (LDCT) impacted health-related quality of life and psychosocial consequences in the Swedish population-based study, Swedish CArdioPulmonary bioImage Study (SCAPIS).</p><p>DESIGN: A prospective cross-sectional study.</p><p>SETTINGS AND PARTICIPANTS: This multicentre (five sites) observational study, which included a cohort from SCAPIS, consisted of 632 participants with indeterminate pulmonary nodules detected with LDCT. These participants continued surveillance for up to 36 months, during which lung cancer was not detected (surveillance group). Additionally, 972 participants with a negative pulmonary LDCT scan were included as a control group. Matching criteria were LDCT date (±2 weeks), gender and site.</p><p>OUTCOME MEASURES: All participants completed a health-related quality of life questionnaire (RAND-36) and the Consequences of Screening (COS) questionnaire, an average of 3 years after LDCT was conducted at entry into SCAPIS.</p><p>RESULTS: Participants were 51-70 years old at study commencement. Overall, the two groups did not differ in demographic or psychosocial variables, smoking habits or pulmonary medical history. Individuals from countries other than Sweden and those with low socioeconomic status were less likely to participate (p&lt;0.001). No effects on health-related quality of life were observed via RAND-36. In COS, the surveillance group demonstrated a higher OR for anxiety about lung cancer (OR 3.96, 95% CI 2.35 to 6.66, p&lt;0.001), experiencing a sense of dejection (OR 1.35, 95% CI 1.06 to 1.72, p=0.015) and thoughts about existential values (OR 1.30, 95% CI 1.04 to 1.60, p=0.018).</p><p>CONCLUSIONS: Lung surveillance with LDCT contributed to significant experiences of sense of dejection, anxiety about lung cancer and development of thoughts about existential values among participants in the surveillance group compared with the controls. The risk of side effects should be communicated for informed decision-making about (non-)attendance in lung cancer screening.</p>}},
  author       = {{Andersson, Elisabeth and Dai Ydrefelt, Ying and Johannesson, Marit and Lundbäck, Maria and Mannila, Maria and Persson, Margaretha and Swahn, Eva and Bolejko, Anetta}},
  issn         = {{2044-6055}},
  language     = {{eng}},
  number       = {{9}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Surveillance of indeterminate pulmonary nodules detected with CT in a Swedish population-based study (SCAPIS) : psychosocial consequences and impact on health-related quality of life-a multicentre prospective cross-sectional study}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2021-048721}},
  doi          = {{10.1136/bmjopen-2021-048721}},
  volume       = {{11}},
  year         = {{2021}},
}