Psychological effects of colorectal cancer screening invitations: a randomized trial

Abstract

Background: Participation in cancer screening programs might cause worries in the population that could outweigh the benefits of reduced mortality. The present study investigated the psychological reactions towards an invitation for colorectal cancer screening (CRC) in Norway. Methods: In a prospective, randomized trial participants were invited to either flexible sigmoidoscopy screening (FS), Faecal Immunochemical test screening (FIT), or no screening (control arm). Together with the invitations participants received a Health-related Quality of Life (HRQoL) questionnaire (The ShortForm-12) and an anxiety and depression questionnaire (Hospital Anxiety and Depression Scale). Findings: Number of invited individuals and questionnaire response rates were; 6845 (42%) in the FS arm, 6886 (52%) in the FIT arm, and 7666 (34%) in the control arm, respectively. The FS participants reported significantly less anxiety, and better HRQoL compared to controls. FIT participants reported lower HRQoL compared to controls. None of the statistical differences were considered clinically relevant, operationalized as a difference of at least half a s.d. Conclusion: The present study indicates the absence of clinically relevant negative reactions after receiving an invitation for CRC screening.