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

M. J. Denters, M. Deutekom, M. L. Essink-Bot, P. M. Bossuyt, P. Fockens, E. Dekker

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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.

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.

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.

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.
Original languageEnglish
Pages (from-to)2809-2815
Number of pages7
JournalSupportive Care in Cancer
Issue number10
Publication statusPublished - Oct 2013
Externally publishedYes


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