Psychological outcomes of low-dose CT lung cancer screening in a multisite demonstration screening pilot: the Lung Screen Uptake Trial (LSUT).
Psychological outcomes of low-dose CT lung cancer screening in a multisite demonstration screening pilot: the Lung Screen Uptake Trial (LSUT).
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DOI：
10.1136/thoraxjnl-2020-215054
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发表时间：
2020-12
期刊：
影响因子：
10
通讯作者：
Quaife SL
中科院分区：
文献类型：
--
作者：
Kummer S;Waller J;Ruparel M;Duffy SW;Janes SM;Quaife SL
先前关于低剂量CT（LDCT）肺癌筛查试验中心理负担的研究可能由于参与偏倚和对照组的痛苦升高而缺乏普遍性。在一个真实世界的筛查示范试点中，目前和以前的吸烟者（n=787，年龄60-75）在三个时间点（T0：预约，T1：第二天，T2：3个月）完成了肺癌担忧的测量，在两个时间点（T0和T2）完成了焦虑和抑郁的测量。具有相同年龄和吸烟特征的“筛查不知情”社区样本（n=383）完成了这些措施一次（T0）。按样本类型和LDCT结果比较平均评分。与社区样本（T0）相比，筛查样本中肺癌担忧的平均评分更高，在T0和T2的校正分析中统计学显著增加（平均值（M）：9.32; 95% CI 8.96至9.69 vs M：11.34; 11.09至11.59和M：11.88; T0和T2时的焦虑（M：3.32; 2.94 - 3.70 vs M：4.73; 4.42 - 5.04和M：5.78; 5.33 - 6.23）和T2时的抑郁（M：3.85; 3.44 - 4.27 vs M：4.15; 3.76 - 4.55）。不确定（例如，T2焦虑M：6.93; 5.65至8.21）和偶然发现（初级保健随访M：5.34; 4.67至6.02）以及不符合筛选条件（M：6.51; 5.25至7.77）的患者得分最高。女性、年轻、无带薪工作、未婚/与伴侣同居和教育程度较低预测T0时的心理结局较差，但调整基线评分后未预测T2。平均评分保持在“正常”临床范围内。在现实环境中接受LDCT筛查的高危人群中，心理困扰增加，但总体差异不太可能具有临床意义。这将是至关重要的监测服务的心理影响纵向跨越不同的设置，包括亚组容易临床升高的痛苦。肺部筛查摄取试验于2015年9月23日在国际标准注册临床/社会研究（ISRCTN）（编号：ISRCTN 21774741）中前瞻性注册，并于2015年9月22日在美国国立卫生研究院ClinicalTrials.gov数据库（NCT 02558101）中前瞻性注册。
Previous studies of psychological burden in low-dose CT (LDCT) lung cancer screening trials may lack generalisability due to participation bias and control arms having elevated distress. Current and former smokers (n=787, aged 60–75) within a real-world screening demonstration pilot completed measures of lung cancer worry at three time points (T0: appointment, T1: next day, T2: 3 months) and anxiety and depression at two time points (T0 and T2). A ‘screening unaware’ community sample (n=383) with the same age and smoking characteristics completed these measures once (T0). Mean scores were compared by sample type and LDCT result. Compared with the community sample (T0), mean scores were higher in the screening sample, and statistically significantly increased in adjusted analyses, for lung cancer worry at T0 and T2 (mean (M): 9.32; 95% CI 8.96 to 9.69 vs M: 11.34; 11.09 to 11.59 and M: 11.88; 11.49 to 12.27), for anxiety at T0 and T2 (M: 3.32; 2.94 to 3.70 vs M: 4.73; 4.42 to 5.04 and M: 5.78; 5.33 to 6.23) and depression at T2 (M: 3.85; 3.44 to 4.27 vs M: 4.15; 3.76 to 4.55). Scores were highest for those with indeterminate (eg, T2 anxiety M: 6.93; 5.65 to 8.21) and incidental findings (primary care follow-up M: 5.34; 4.67 to 6.02) and those ineligible for screening (M: 6.51; 5.25 to 7.77). Being female, younger, not in paid employment, not married/cohabiting with a partner and lower education predicted poorer psychological outcomes at T0, but not T2 after adjusting for baseline scores. Mean scores remained within ‘normal’ clinical ranges. Psychological distress was raised among high-risk individuals undergoing LDCT screening in a real-world setting, but overall differences were unlikely to be clinically meaningful. It will be critical to monitor the psychological impact of services longitudinally across diverse settings, including subgroups vulnerable to clinically elevated distress. The Lung Screen Uptake Trial was registered prospectively with the International Standard Registered Clinical/soCial sTudy (ISRCTN) (Number: ISRCTN21774741) on 23 September 2015 and the National Institutes of Health ClinicalTrials.gov database (NCT02558101) on 22 September 2015.
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影响因子：
8.8
作者：
通讯作者：
--
影响因子：
5.3
作者：
Rasmussen, Jakob F.;Siersma, V.;Brodersen, J.
通讯作者：
Brodersen, J.
DOI：
10.1093/jnci/85.13.1074
发表时间：
1993-07-07
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
LERMAN, C;DALY, M;ENGSTROM, P
通讯作者：
ENGSTROM, P
影响因子：
24.3
作者：
van den Bergh, K. A. M.;Essink-Bot, M. L.;de Koning, H. J.
通讯作者：
de Koning, H. J.
影响因子：
10.3
作者：
Aberle, Denise R.;Adams, Amanda M.;Pinsky, Paul F.
通讯作者：
Pinsky, Paul F.