False-positive cancer screens and health-related quality of life.
False-positive cancer screens and health-related quality of life.
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假阳性癌症筛查和健康相关的生活质量。
DOI：
10.1097/00002820-200409000-00003
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发表时间：
2004
期刊：
影响因子：
2.6
通讯作者：
Church,TimothyR
中科院分区：
文献类型：
--
作者：
McGovern,PatriciaM;Gross,CynthiaR;Krueger,RichardA;Engelhard,DeborahA;Cordes,JillE;Church,TimothyR
通过设计，筛选测试是不完美的——对某些癌症没有反应（假阴性），偶尔会引起对不存在的癌症的怀疑（假阳性）。本初步研究描述了患者对假阳性癌症筛查试验的反应，并确定了筛查对健康相关生活质量（HRQoL）的影响。试验结果提示了一些重要的问题，可以纳入未来评估前列腺癌、肺癌、结肠癌或卵巢癌（PLCO）筛查的影响。进行了七个焦点小组，以确定PLCO筛查的所有阶段的性质和意义。在前列腺癌、肺癌、结直肠癌和卵巢癌筛查试验中完成筛查且至少有1例假阳性筛查的明尼苏达州参与者（N= 47）。参与者对异常筛查和诊断检查的反应主要是情绪上的（例如，焦虑和痛苦），而不是身体上的，最终对大多数人来说是积极的。健康困扰和对癌症和死亡的恐惧是确定的HRQoL的主要负面方面。这些概念通常不包括在一般的HRQoL问卷中，如SF-36，但与PLCO筛查高度相关。临床医生被认为低估了后续诊断测试的不适。然而，对大多数参与者来说，宽慰和确信似乎最终超过了负面情绪。对肿瘤护士的启示包括需要考虑与筛查信度和效度相关的筛查的情感后果。
By design, screening tests are imperfect—unresponsive to some cancers (false negatives) while occasionally raising suspicion of cancer where none exists (false positives). This pilot study describes patients' responses to having a false-positive screening test for cancer, and identifies screening effects on health-related quality of life (HRQoL). The pilot findings suggest issues important for incorporation in future evaluations of the impact of screening for prostate, lung, colon, or ovarian (PLCO) cancers. Seven focus groups were conducted to identify the nature and meaning of all phases of PLCO screening. Minnesota participants in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial who had completed screening, with at least 1 false-positive screen, participated (N= 47). Participants' reactions to abnormal screens and diagnostic work-ups were primarily emotional (eg, anxiety and distress), not physical, and ultimately positive for the majority. Health distress and fear of cancer and death were the major negative aspects of HRQoL identified. These concepts are not typically included in generic HRQoL questionnaires like the SF-36, but are highly relevant to PLCO screening. Clinicians were regarded as underestimating the discomfort of follow-up diagnostic testing. However, relief and assurance appeared to eventually outweigh the negative emotions for most participants. Implications for oncology nurses include the need to consider the emotional consequences of screening in association with screen reliability and validity.