Psychological morbidity associated with ovarian cancer screening: results from more than 23 000 women in the randomised trial of ovarian cancer screening (UKCTOCS). (28th May 2014)

• Record Type: Journal Article
• Authors: Barrett, J; Jenkins, V; Farewell, V; Menon, U; Jacobs, I; Kilkerr, J; Ryan, A; Langridge, C; Fallowfield, L; UKCTOCS trialists
• Is Part Of: BJOG. Volume 121:Number 9(2014:Sep.)
• Page Start: 1071
• Page End: 1079
• Publication Date: 2014-05-28
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12870
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12870-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12870-sec-0001" sec-type="section"> <title>Objective</title> <p>To examine the psychological sequelae associated with abnormal screening in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).</p> </sec> <sec id="bjo12870-sec-0002" sec-type="section"> <title>Design</title> <p>Prospective, longitudinal randomised control trial.</p> </sec> <sec id="bjo12870-sec-0003" sec-type="section"> <title>Setting</title> <p>Sixteen UKCTOCS centres.</p> </sec> <sec id="bjo12870-sec-0004" sec-type="section"> <title>Sample</title> <p>Women aged 50–70 years randomised to annual multimodal screening, ultrasound screening or control groups.</p> </sec> <sec id="bjo12870-sec-0005" sec-type="section"> <title>Methods</title> <p>Two groups were followed for 7 years: (1) a random sample (<italic>n </italic>= 1339), taken from all three study groups; and (2) an events sample (<italic>n </italic>= 22 035) of women with abnormal screens resulting in the need for repeat testing of either low or higher level intensity.</p> </sec> <sec id="bjo12870-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Patient‐reported measures of anxiety (scores ranging from 20 to 80) and psychological morbidity.</p> </sec> <sec id="bjo12870-sec-0007" sec-type="section"> <title>Results</title> <p>In the random sample the mean difference between anxiety scores after a repeat screening and those following an annual screening was 0.4 (95% CI −0.46, 1.27), and in the events sample it was 0.37 (95% CI 0.23, 0.51). The risk of psychological morbidity was only increased in the event sample for women requiring higher level repeat screening (OR 1.28; 95% CI 1.18, 1.39). The risk of psychological morbidity in women with ovarian cancer was higher at both 6 weeks (OR 16.2; 95% CI 9.19, 28.54) and 6 months (OR 3.32; 95% CI 1.91, 5.77) following surgery.</p> </sec> <sec id="bjo12870-sec-0008" sec-type="section"> <title>Conclusions</title> <p>Screening does not appear to raise anxiety but psychological morbidity is elevated by more intense repeat testing following abnormal annual screens, and in women after surgical treatment for ovarian cancer.</p> </sec> </abstract>