Screening For Colorectal Cancer Not Linked To Psychological Harm

Benedicte Kirkøen, PhD candidate Bowel Cancer Screening in Norway – a pilot study Cancer Registry of Norway (Kreftregisteret)

Benedicte Kirkøen Interview with:
Benedicte Kirkøen, PhD candidate
Bowel Cancer Screening in Norway – a pilot study
Cancer Registry of Norway (Kreftregisteret) What is the background for this study?

Response: Randomised controlled trials have demonstrated that screening for colorectal cancer (CRC) can reduce CRC related mortality, but the total benefit and harm of national cancer screening programmes are under debate. Saving relatively few lives requires a large number of people to be screened. Most people who attend screening will never develop cancer, but may be exposed to potential psychological stress by participation. Cancer is one of the largest threats to peoples’ health, and participating in screening for cancer might therefore cause anxiety.

In Norway, colorectal cancer incidence has nearly tripled since the 1950s, and currently a large randomised pilot study of a national screening programme (Bowel Cancer Screening in Norway) is investigating the effect of screening on reduction in CRC incidence and mortality. As part of an evaluation of the benefits and harms of the pilot, we investigated the psychological effect of screening participation in a large group of participants. Of particular interest to us were participants who received a positive screening result and were referred to colonoscopy. What are the main findings?

Response: Participants completed questionnaires measuring anxiety, depression and HRQOL before screening participation, and after they received positive or negative screening results.

We found that receiving a positive colorectal cancer screening result, and participating in CRC screening did not cause short-term psychological harm in participants. What should clinicians and patients take away from your report?

Response: It is reassuring that on a population level, participating in colorectal cancer screening did not cause psychological harm. What recommendations do you have for future research as a result of this study?

Response: Many studies on the psychological effects of screening measure anxiety in participants after receipt of their screening results. These studies compare anxiety in participants who receive positive and negative results. However, these groups might be not be comparable. Our research show that groups of screening participants might have different scores at a given time, but that their change from before to after screening is very small. Future studies should include a baseline measure and document changes within participants. Thank you for your contribution to the community.



Br J Cancer. 2016 Mar 1;114(5):497-504. doi: 10.1038/bjc.2016.14. Epub 2016 Feb 11.

Do no harm: no psychological harm from colorectal cancer screening.

Kirkøen B1,2, Berstad P1,3, Botteri E1,4, Åvitsland TL5, Ossum AM6, de Lange T1,5, Hoff G1,3,7, Bernklev T2,3.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Dr. Benedicte Kirkøen (2016). Screening For Colorectal Cancer Not Linked To Psychological