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Portrait of Anetta Bolejko. Photo

Anetta Bolejko

Associate professor, Principal investigator

Portrait of Anetta Bolejko. Photo

Surveillance of indeterminate pulmonary nodules detected with CT in a Swedish population-based study (SCAPIS) : psychosocial consequences and impact on health-related quality of life-a multicentre prospective cross-sectional study

Author

  • Elisabeth Andersson
  • Ying Dai Ydrefelt
  • Marit Johannesson
  • Maria Lundbäck
  • Maria Mannila
  • Margaretha Persson
  • Eva Swahn
  • Anetta Bolejko

Summary, in English

OBJECTIVES: To investigate whether surveillance of pulmonary nodules detected with low-dose CT (LDCT) impacted health-related quality of life and psychosocial consequences in the Swedish population-based study, Swedish CArdioPulmonary bioImage Study (SCAPIS).

DESIGN: A prospective cross-sectional study.

SETTINGS AND PARTICIPANTS: This multicentre (five sites) observational study, which included a cohort from SCAPIS, consisted of 632 participants with indeterminate pulmonary nodules detected with LDCT. These participants continued surveillance for up to 36 months, during which lung cancer was not detected (surveillance group). Additionally, 972 participants with a negative pulmonary LDCT scan were included as a control group. Matching criteria were LDCT date (±2 weeks), gender and site.

OUTCOME MEASURES: All participants completed a health-related quality of life questionnaire (RAND-36) and the Consequences of Screening (COS) questionnaire, an average of 3 years after LDCT was conducted at entry into SCAPIS.

RESULTS: Participants were 51-70 years old at study commencement. Overall, the two groups did not differ in demographic or psychosocial variables, smoking habits or pulmonary medical history. Individuals from countries other than Sweden and those with low socioeconomic status were less likely to participate (p<0.001). No effects on health-related quality of life were observed via RAND-36. In COS, the surveillance group demonstrated a higher OR for anxiety about lung cancer (OR 3.96, 95% CI 2.35 to 6.66, p<0.001), experiencing a sense of dejection (OR 1.35, 95% CI 1.06 to 1.72, p=0.015) and thoughts about existential values (OR 1.30, 95% CI 1.04 to 1.60, p=0.018).

CONCLUSIONS: Lung surveillance with LDCT contributed to significant experiences of sense of dejection, anxiety about lung cancer and development of thoughts about existential values among participants in the surveillance group compared with the controls. The risk of side effects should be communicated for informed decision-making about (non-)attendance in lung cancer screening.

Department/s

  • Internal Medicine - Epidemiology
  • EpiHealth: Epidemiology for Health
  • LUCC: Lund University Cancer Centre
  • Care in high technological environments
  • Radiology Diagnostics, Malmö

Publishing year

2021

Language

English

Publication/Series

BMJ Open

Volume

11

Issue

9

Document type

Journal article

Publisher

BMJ Publishing Group

Topic

  • Radiology, Nuclear Medicine and Medical Imaging
  • Cancer and Oncology

Status

Published

Research group

  • Internal Medicine - Epidemiology
  • Care in high technological environments
  • Radiology Diagnostics, Malmö

ISBN/ISSN/Other

  • ISSN: 2044-6055