Lung cancer CT screening

Psychological responses in the presence and absence of pulmonary nodules

Marcia E. Clark, Laura E. Bedford, Ben Young, John F. R. Robertson, Roshan das Nair, Kavita Vedhara, Roberta Littleford, Francis M. Sullivan, Frances S. Mair, Stuart Schembri, Petra Rauchhaus, Denise Kendrick (Lead / Corresponding author)

Research output: Contribution to journalArticle

Abstract

Objectives: To determine the psychological response (thoughts, perceptions and affect) to a diagnosis of pulmonary nodules following a novel antibody blood test and computed tomography (CT) scans within a UK population.

Materials and methods: This study was nested within a randomised controlled trial of a blood test (Early CDT®-Lung test), followed by a chest x-ray and serial CT-scanning of those with a positive blood test for early detection of lung cancer (ECLS Study). Trial participants with a positive Early CDT®-Lung test were invited to participate (n = 338) and those agreeing completed questionnaires assessing psychological outcomes at 1, 3 and 6 months following trial recruitment. Responses of individuals with pulmonary nodules on their first CT scan were compared to those without (classified as normal CT) at 3 and 6 months follow-up using random effects regression models to account for multiple observations per participant, with loge transformation of data where modelling assumptions were not met.

Results: There were no statistically significant differences between the nodule and normal CT groups in affect, lung cancer worry, health anxiety, illness perceptions, lung cancer risk perception or intrusive thoughts at 3 or 6 months post-recruitment. The nodule group had statistically significantly fewer avoidance symptoms compared to the normal CT group at 3 months (impact of events scale avoidance (IES-A) difference between means −1.99, 95%CI −4.18, 0.21) than at 6 months (IES-A difference between means 0.88, 95%CI −1.32, 3.08; p-value for change over time = 0.003) with similar findings using loge transformed data.

Conclusion: A diagnosis of pulmonary nodules following an Early CDT®-Lung test and CT scan did not appear to result in adverse psychological responses compared to those with a normal CT scan.

Original languageEnglish
Pages (from-to)160-167
Number of pages8
JournalLung Cancer
Volume124
Early online date3 Aug 2018
DOIs
Publication statusPublished - Oct 2018

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Lung Neoplasms
Tomography
Psychology
Lung
Hematologic Tests
Early Detection of Cancer
Thorax
Anxiety
Randomized Controlled Trials
X-Rays
Antibodies
Health
Population

Keywords

  • Lung cancer screening
  • Psychological impact
  • Pulmonary nodules

Cite this

Clark, M. E., Bedford, L. E., Young, B., Robertson, J. F. R., das Nair, R., Vedhara, K., ... Kendrick, D. (2018). Lung cancer CT screening: Psychological responses in the presence and absence of pulmonary nodules. Lung Cancer, 124, 160-167. https://doi.org/10.1016/j.lungcan.2018.08.001
Clark, Marcia E. ; Bedford, Laura E. ; Young, Ben ; Robertson, John F. R. ; das Nair, Roshan ; Vedhara, Kavita ; Littleford, Roberta ; Sullivan, Francis M. ; Mair, Frances S. ; Schembri, Stuart ; Rauchhaus, Petra ; Kendrick, Denise. / Lung cancer CT screening : Psychological responses in the presence and absence of pulmonary nodules. In: Lung Cancer. 2018 ; Vol. 124. pp. 160-167.
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abstract = "Objectives: To determine the psychological response (thoughts, perceptions and affect) to a diagnosis of pulmonary nodules following a novel antibody blood test and computed tomography (CT) scans within a UK population.Materials and methods: This study was nested within a randomised controlled trial of a blood test (Early CDT{\circledR}-Lung test), followed by a chest x-ray and serial CT-scanning of those with a positive blood test for early detection of lung cancer (ECLS Study). Trial participants with a positive Early CDT{\circledR}-Lung test were invited to participate (n = 338) and those agreeing completed questionnaires assessing psychological outcomes at 1, 3 and 6 months following trial recruitment. Responses of individuals with pulmonary nodules on their first CT scan were compared to those without (classified as normal CT) at 3 and 6 months follow-up using random effects regression models to account for multiple observations per participant, with loge transformation of data where modelling assumptions were not met.Results: There were no statistically significant differences between the nodule and normal CT groups in affect, lung cancer worry, health anxiety, illness perceptions, lung cancer risk perception or intrusive thoughts at 3 or 6 months post-recruitment. The nodule group had statistically significantly fewer avoidance symptoms compared to the normal CT group at 3 months (impact of events scale avoidance (IES-A) difference between means −1.99, 95{\%}CI −4.18, 0.21) than at 6 months (IES-A difference between means 0.88, 95{\%}CI −1.32, 3.08; p-value for change over time = 0.003) with similar findings using loge transformed data.Conclusion: A diagnosis of pulmonary nodules following an Early CDT{\circledR}-Lung test and CT scan did not appear to result in adverse psychological responses compared to those with a normal CT scan.",
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Clark, ME, Bedford, LE, Young, B, Robertson, JFR, das Nair, R, Vedhara, K, Littleford, R, Sullivan, FM, Mair, FS, Schembri, S, Rauchhaus, P & Kendrick, D 2018, 'Lung cancer CT screening: Psychological responses in the presence and absence of pulmonary nodules', Lung Cancer, vol. 124, pp. 160-167. https://doi.org/10.1016/j.lungcan.2018.08.001

Lung cancer CT screening : Psychological responses in the presence and absence of pulmonary nodules. / Clark, Marcia E.; Bedford, Laura E.; Young, Ben; Robertson, John F. R.; das Nair, Roshan; Vedhara, Kavita; Littleford, Roberta; Sullivan, Francis M.; Mair, Frances S.; Schembri, Stuart; Rauchhaus, Petra; Kendrick, Denise (Lead / Corresponding author).

In: Lung Cancer, Vol. 124, 10.2018, p. 160-167.

Research output: Contribution to journalArticle

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T1 - Lung cancer CT screening

T2 - Psychological responses in the presence and absence of pulmonary nodules

AU - Clark, Marcia E.

AU - Bedford, Laura E.

AU - Young, Ben

AU - Robertson, John F. R.

AU - das Nair, Roshan

AU - Vedhara, Kavita

AU - Littleford, Roberta

AU - Sullivan, Francis M.

AU - Mair, Frances S.

AU - Schembri, Stuart

AU - Rauchhaus, Petra

AU - Kendrick, Denise

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N2 - Objectives: To determine the psychological response (thoughts, perceptions and affect) to a diagnosis of pulmonary nodules following a novel antibody blood test and computed tomography (CT) scans within a UK population.Materials and methods: This study was nested within a randomised controlled trial of a blood test (Early CDT®-Lung test), followed by a chest x-ray and serial CT-scanning of those with a positive blood test for early detection of lung cancer (ECLS Study). Trial participants with a positive Early CDT®-Lung test were invited to participate (n = 338) and those agreeing completed questionnaires assessing psychological outcomes at 1, 3 and 6 months following trial recruitment. Responses of individuals with pulmonary nodules on their first CT scan were compared to those without (classified as normal CT) at 3 and 6 months follow-up using random effects regression models to account for multiple observations per participant, with loge transformation of data where modelling assumptions were not met.Results: There were no statistically significant differences between the nodule and normal CT groups in affect, lung cancer worry, health anxiety, illness perceptions, lung cancer risk perception or intrusive thoughts at 3 or 6 months post-recruitment. The nodule group had statistically significantly fewer avoidance symptoms compared to the normal CT group at 3 months (impact of events scale avoidance (IES-A) difference between means −1.99, 95%CI −4.18, 0.21) than at 6 months (IES-A difference between means 0.88, 95%CI −1.32, 3.08; p-value for change over time = 0.003) with similar findings using loge transformed data.Conclusion: A diagnosis of pulmonary nodules following an Early CDT®-Lung test and CT scan did not appear to result in adverse psychological responses compared to those with a normal CT scan.

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