Screening for Ovarian Cancer: Psychobehavioral Outcomes

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DESCRIPTION (provided by applicant): Transvaginal sonography (TVS) can facilitate early detection of ovarian cancer (OC), however, like all cancer screening tests, TVS yields a proportion of "abnormal" findings. While the vast majority of abnormal TVS results are benign, the impact of this potentially stressful screening experience upon affective, cognitive, and behavioral outcomes has not been adequately examined. The proposed research builds on our current study (R01 CA84036) of psychological and behavioral outcomes associated with routine TVS screening by focusing explicitly on the impact of an abnormal TVS result. Women (n=400) receiving an abnormal TVS result during routine screening (Abnormal Screening (AS) group) and returning for a repeat TVS test four-eight weeks later will be matched (age, prior screening history) with women (n=400) receiving a normal TVS result during routine screening (Routine Screening (RS) group). All women will complete a baseline assessment prior to either routine (RS group) or repeat (AS group) TVS screening and follow-up assessments 1,4, and 18 months post-baseline. Some women (n=120) in the AS group will complete an additional "true" baseline assessment prior to the routine TVS test yielding their abnormal result. Measures of dispositional variables (optimism, monitoring, emotional approach coping) are obtained at baseline and affective (e.g., OC-specific distress), cognitive (e.g., OC risk perception, TVS efficacy beliefs, benefit finding), and behavioral (e.g., OC-specific monitoring behavior, emotional approach coping, participation in screening for breast/colon cancers) endpoints will be assessed longitudinally. Adherence with recommendations for routine TVS screening will be monitored by OC screening program records. Several contemporary theoretical models of response to stressful events (Cognitive-Social Health Information Processing, Monitoring Process, Social-Cognitive Processing) guide selection of study variables and provide specific hypotheses for testing. Three specific aims will be addressed: (1) characterize the impact of an abnormal TVS result with regard to the nature, magnitude, valence, and trajectory of outcomes; (2) identify clinical, demographic, dispositional, and psychosocial variables associated with magnitude and persistence of these outcomes; and (3) develop and pilot test an appropriate psycho educational intervention for minimizing negative outcomes after an abnormal TVS result. Results will enhance understanding of response to abnormal results in response to screening for OC and will also enhance understanding of response to abnormal screening results for other malignant and nonmalignant conditions.