Psychological Distress after a Positive Fecal Occult Blood Test Result among Members of an Integrated Healthcare Delivery System
Menée auprès de 2 260 participants (âge moyen : 59 ans), cette étude américaine analyse leur anxiété et leur détresse psychologique après un résultat positif au test de recherche de sang occulte dans les selles
Résumé en anglais
Background: Colorectal cancer screening (CRCS) reduces morbidity and mortality; however, the positive benefits might be partially offset by long-term distress following positive screening results. We examined relationships among CRC-specific worry and situational anxiety after positive fecal occult blood tests [FOBT (+)] compared to receipt of negative results.
Methods: 2,260 eligible members of Group Health, an integrated healthcare delivery system, completed baseline surveys and received FOBT screening kits, with 1,467 members returning the kits. We matched FOBT (+) patients (n = 55) 2:1 on age and sex with FOBT (-) respondents (n = 110). Both groups completed follow-up surveys at 7-14 days and 4-months post screening. We assessed situational anxiety (State-Trait Anxiety Inventory, STAI), CRC worry frequency, and mood disturbance.
Results: Mean age was 59 years, majority were women (62%) and white (89%). After adjusting for age, sex and baseline worry, at 7-14 days post screening, FOBT (+) group were 3.82 (95% CI: 1.09, 13.43) times more likely to report CRC-related mood disturbances and significantly higher mean STAI scores than FOBT (-) group, (mean =38.8 versus 30.9, p=0.007). At 4 months post-test, mood disturbances and situational anxiety appeared to drop to baseline levels for FOBT (+). No colon cancer worry frequency was observed.
Conclusions: FOBT (+) results are associated with short-term situational anxiety and CRC-specific mood disturbances.
Impact: Distress from FOBT (+) result declined to near baseline levels by 4 months. Additional studies are needed to clarify the relationship between long-term distress and follow-up colonoscopy.
