Abstract

Objective: The objective of this study was to investigate the psychosocial consequences of receiving false-positive colorectal cancer (CRC) screening results, following a positive immunochemical faecal occult blood test.Design, setting, and subjects: We conducted a qualitative study with four semi-structured focus group interviews with 16 participants aged 50–74, all of whom had received a false-positive result in the national Danish CRC screening programme. We selected, recruited, and grouped participants to ensure maximum variation, and to enable a level of confidence to speak openly about experiences of screening. We subjected interview data, audio-recordings, and transcripts to a strategy of qualitative analysis called systematic text condensation.Results: We identified four main themes which described the psychosocial consequences of false-positive CRC screening results: anxiety; discomfort; changed self-perception and behaviour; and considerations on participation in screening. Each of these themes covered a wide range of experiences which were relevant to the informants and broadly shared by them in many aspects.Conclusions: Receiving false-positive results from CRC screening can lead to negative psychosocial consequences such as changes in self-perception and anxiety: some participants may experience subsequent relief, others not. These negative psychosocial consequences might persist over time.Implications: Negative psychosocial consequences from false-positive CRC screening results may result in a greater use of general practitioner services by healthy people who need reassurance or further tests. More research using condition-specific measures is required to further understand the degree and potential persistence of psychosocial consequences of false-positive results from CRC screening.Key PointsParticipants who receive false-positive colorectal cancer (CRC) screening results may experience negative psychosocial consequences e.g. anxiety and subsequent relief.Participants who receive false-positive CRC screening results may experience discomfort during the screening process.Participants who receive false-positive CRC screening results may experience longer term changes of self-perception.Participants who receive false-positive CRC screening results may experience ambivalence about the offered diagnostic down-stream procedures including colonoscopy.

Highlights

  • Mass medical screening is a broadly accepted but fairly blunt instrument that roughly separates screening participants into two groups: one with a high risk and one with a low risk of having the condition screened for

  • The objective of this study was to investigate the psychosocial consequences of receiving false-positive colorectal cancer (CRC) screening results, following a positive immunochemical faecal occult blood test

  • Design, setting, and subjects: We conducted a qualitative study with four semi-structured focus group interviews with 16 participants aged 50–74, all of whom had received a false-positive result in the national Danish CRC screening programme

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Summary

Introduction

Mass medical screening is a broadly accepted but fairly blunt instrument that roughly separates screening participants into two groups: one with a high risk and one with a low risk of having the condition screened for. Screening has the potential to lead to intended benefits and unintended harms [1,2,3]. The benefits of screening must outweigh the physical, psychological, and social harms to the individual as well as the economic and social consequences for society [1,4].

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