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False-positive cancer screens and health-related quality of life.

Authors
McGovern-PM; Gross-CR; Krueger-RA; Engelhard-DA; Cordes-JE; Church-TR
Source
Cancer Nurs 2004 Sep-Oct; 27(5):347-352
NIOSHTIC No.
20037474
Abstract
By design, screening tests are imperfect-unresponsive to some cancers (false negatives) while occasionally raising suspicion of cancer where none exists (false positives). This pilot study describes patients' responses to having a false-positive screening test for cancer, and identifies screening effects on health-related quality of life (HRQoL). The pilot findings suggest issues important for incorporation in future evaluations of the impact of screening for prostate, lung, colon, or ovarian (PLCO) cancers. Seven focus groups were conducted to identify the nature and meaning of all phases of PLCO screening. Minnesota participants in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial who had completed screening, with at least 1 false-positive screen, participated (N = 47). Participants' reactions to abnormal screens and diagnostic work-ups were primarily emotional (eg, anxiety and distress), not physical, and ultimately positive for the majority. Health distress and fear of cancer and death were the major negative aspects of HRQoL identified. These concepts are not typically included in generic HRQoL questionnaires like the SF-36, but are highly relevant to PLCO screening. Clinicians were regarded as underestimating the discomfort of follow-up diagnostic testing. However, relief and assurance appeared to eventually outweigh the negative emotions for most participants. Implications for oncology nurses include the need to consider the emotional consequences of screening in association with screen reliability and validity.
Keywords
Analytical-processes; Cancer-rates; Diagnostic-tests; Disaster-prevention; Emotional-stress; Health-care-facilities; Health-care-personnel; Medical-personnel; Medical-screening; Nurses; Psychological-effects; Psychological-reactions; Psychological-responses; Psychological-stress; Qualitative-analysis; Questionnaires; Statistical-analysis; Stress
Contact
Patricia M McGovern, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Mayo Del Code 807, 420 Delaware Street SE, Minneapolis, MN 55455
Publication Date
20040901
Document Type
Journal Article
Email Address
pmcg@umn.edu
Funding Type
Grant
Fiscal Year
2004
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-OH-008434
Issue of Publication
5
ISSN
0162-220X
Source Name
Cancer Nursing
State
MN
Performing Organization
University of Minnesota Twin Cities
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