Psychological distress after a positive fecal occult blood test result among members of an integrated healthcare delivery system.

Authors:
Laing Sharon S, PhD
Laing Sharon S, PhD
University of Washington Tacoma
Assistant Professor of Nursing and Healthcare Leadership
Tacoma, Washington | United States

Cancer Epidemiol Biomarkers Prev 2014 Jan 12;23(1):154-9. Epub 2013 Nov 12.

Authors' Affiliations: Health Promotion Research Center, University of Washington; Department of Epidemiology, University of Washington; Group Health Research Institute, Seattle; and Department of Psychology, Eastern Washington University, Bellevue, Washington.

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 colorectal cancer-specific worry and situational anxiety after positive fecal occult blood tests [FOBT (+)] compared with receipt of negative results.

Methods: Of note, 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) 1:2 on age and sex with FOBT (-) respondents (n = 110). Both groups completed follow-up surveys at 7 to 14 days and 4 months after screening. We assessed situational anxiety (State-Trait Anxiety Inventory, STAI), colorectal cancer worry frequency, and mood disturbance.

Results: Mean age was 59 years, and majority were women (62%) and White (89%). After adjusting for age, sex, and baseline worry, at 7 to 14 days after screening, the FOBT (+) group was 3.82 [95% confidence interval (CI), 1.09-13.43] times more likely to report colorectal cancer-related mood disturbances and significantly higher mean STAI scores than the FOBT (-) group (mean = 38.8 vs. 30.9; P = 0.007). At 4-month posttest, mood disturbances and situational anxiety seemed 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 colorectal cancer-specific mood disturbances.

Impact: Distress from FOBT (+) results declined to near-baseline levels by 4 months. Additional studies are needed to clarify the relationship between long-term distress and follow-up colonoscopy.

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Source
http://dx.doi.org/10.1158/1055-9965.EPI-13-0722DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3947142PMC
January 2014
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5 Citations
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