Skip to main content

FIT false-positives in colorectal cancer screening experience psychological distress up to 6 weeks after colonoscopy

Supportive Care in Cancer volume 21, pages 2809–2815 (2013)Cite this article

Abstract

Purpose

Screening programs for colorectal cancer aim at reducing cancer mortality. We assessed psychological effects of being invited to an immunochemical fecal test (FIT)-based screening program.

Methods

Asymptomatic persons aged 50–74 years were invited to a Dutch screening pilot. The Psychological Consequences Questionnaire (PCQ) was used to measure the psychological effects of screening. Screen positives had two additional measurements: before undergoing the colonoscopy and 4 weeks after receiving the colonoscopy findings.

Results

A number of 3,828 invitees (46 % male, mean age 60 years) completed the first PCQ. FIT positives had a higher mean total PCQ score (8.32, SD 8.84; score range 0–36) than those who declined participation (3.72, SD 6.30); participants still waiting for their FIT result had a mean score of 2.74 (SD 5.11), and those with a negative FIT result had the lowest score (2.06, SD 4.43) (p < 0.001). In the 373 FIT positives who underwent colonoscopy, 195 completed the pre-colonoscopy questionnaire and 253, the post-colonoscopy questionnaire. Mean total, physical, and social PCQ scores had decreased significantly between the first questionnaire and the pre-colonoscopy one, but scores on the emotional subscale did not. In false-positives, mean total, physical, and emotional PCQ scores decreased significantly, while in true-positives, a significant decrease in mean emotional PCQ score was observed.

Conclusion

Psychological consequences for invitees to a Dutch FIT-based colorectal cancer screening pilot differ, depending on timing and FIT result. FIT positives are more distressed than FIT negatives. FIT positives still experience psychological distress 6 weeks after a normal colonoscopy.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Barton MB, Morley DS, Moore S, Allen JD, Kleinman KP, Emmons KM, Fletcher SW (2004) Decreasing women’s anxieties after abnormal mammograms: a controlled trial. J Natl Cancer Inst 96:529–538

    Article  PubMed  Google Scholar 

  2. Bowland L, Cockburn J, Cawson J, Anderson HC, Moorehead S, Kenny M (2003) Counselling interventions to address the psychological consequences of screening mammography: a randomised trial. Patient Educ Couns 49:189–198

    Article  PubMed  Google Scholar 

  3. Gilbert FJ, Cordiner CM, Affleck IR, Hood DB, Mathieson D, Walker LG (1998) Breast screening: the psychological sequelae of false-positive recall in women with and without a family history of breast cancer. Eur J Cancer 34:2010–2014

    Article  CAS  PubMed  Google Scholar 

  4. Lowe JB, Balanda KP, Del MC, Hawes E (1999) Psychologic distress in women with abnormal findings in mass mammography screening. Cancer 85:1114–1118

    Article  CAS  PubMed  Google Scholar 

  5. Meystre-Agustoni G, Paccaud F, Jeannin A, Dubois-Arber F (2001) Anxiety in a cohort of Swiss women participating in a mammographic screening programme. J Med Screen 8:213–219

    Article  CAS  PubMed  Google Scholar 

  6. Olsson P, Armelius K, Nordahl G, Lenner P, Westman G (1999) Women with false positive screening mammograms: how do they cope? J Med Screen 6:89–93

    Article  CAS  PubMed  Google Scholar 

  7. Sandin B, Chorot P, Valiente RM, Lostao L, Santed MA (2002) Adverse psychological effects in women attending a second-stage breast cancer screening. J Psychosom Res 52:303–309

    Article  PubMed  Google Scholar 

  8. Scaf-Klomp W, Sanderman R, van de Wiel HB, Otter R, van den Heuvel WJ (1997) Distressed or relieved? Psychological side effects of breast cancer screening in The Netherlands. J Epidemiol Community Health 51:705–710

    Article  CAS  PubMed  Google Scholar 

  9. Salz T, Richman AR, Brewer NT (2010) Meta-analyses of the effect of false-positive mammograms on generic and specific psychosocial outcomes. Psychooncology 19:1026–1034

    Article  PubMed  Google Scholar 

  10. Brett J, Austoker J (2001) Women who are recalled for further investigation for breast screening: psychological consequences 3 years after recall and factors affecting re-attendance. J Public Health Med 23:292–300

    Article  CAS  PubMed  Google Scholar 

  11. Brett J, Bankhead C, Henderson B, Watson E, Austoker J (2005) The psychological impact of mammographic screening. A systematic review. Psychooncology 14:917–938

    Article  CAS  PubMed  Google Scholar 

  12. Brasso K, Ladelund S, Frederiksen BL, Jorgensen T (2010) Psychological distress following fecal occult blood test in colorectal cancer screening—a population-based study. Scand J Gastroenterol 45:1211–1216

    Article  PubMed  Google Scholar 

  13. Lindholm E, Berglund B, Kewenter J, Haglind E (1997) Worry associated with screening for colorectal carcinomas. Scand J Gastroenterol 32:238–245

    Article  CAS  PubMed  Google Scholar 

  14. Denters MJ, Deutekom M, Fockens P, Bossuyt PM, Dekker E (2009) Implementation of population screening for colorectal cancer by repeated fecal occult blood test in the Netherlands. BMC Gastroenterol 9:28

    Article  PubMed  Google Scholar 

  15. van Rossum LG, van Rijn AF, Laheij RJ, van Oijen MG, Fockens P, van Krieken HH, Verbeek AL, Jansen JB, Dekker E (2008) Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population. Gastroenterology 135:82–90

    Article  PubMed  Google Scholar 

  16. Nagengast F, Kaandorp C (2002) Follow-up na poliepectomie. Herziene richtlijn. Kwalititeitsinstituut voor de Gezondheidszorg CBO

  17. Cockburn J, De LT, Hurley S, Clover K (1992) Development and validation of the PCQ: a questionnaire to measure the psychological consequences of screening mammography. Soc Sci Med 34:1129–1134

    Article  CAS  PubMed  Google Scholar 

  18. Rijnsburger AJ, Essink-Bot ML, van As E, Cockburn J, de Koning HJ (2006) Measuring psychological consequences of screening: adaptation of the psychological consequences questionnaire into Dutch. Qual Life Res 15:933–940

    Article  CAS  PubMed  Google Scholar 

  19. Korfage IJ, van Ballegooijen M, Huveneers H, Essink-Bot ML (2010) Anxiety and borderline PAP smear results. Eur J Cancer 46:134–141

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank ZonMW for funding (project numbers 120710007 and 63000004). We also thank the Comprehensive Cancer Center Amsterdam for their contributions to the study and Karin de Groot for research assistance.

Conflict of interest

None

Author information

Affiliations

  1. Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    M. J. Denters, P. Fockens & E. Dekker

  2. Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    M. Deutekom & M. L. Essink-Bot

  3. Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    P. M. Bossuyt

Authors
  1. M. J. Denters
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Deutekom
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. L. Essink-Bot
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. M. Bossuyt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Fockens
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Dekker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Dekker.

Additional information

Trial Registration Number: NTR1327

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Denters, M.J., Deutekom, M., Essink-Bot, M.L. et al. FIT false-positives in colorectal cancer screening experience psychological distress up to 6 weeks after colonoscopy. Support Care Cancer 21, 2809–2815 (2013). https://doi.org/10.1007/s00520-013-1867-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-013-1867-7

Keywords

  • Psychological consequences of screening
  • Mass screening
  • Colorectal cancer
  • Fecal immunochemical test (FIT)
  • Epidemiology