There's a concern that the high rate of false positive results associated with screening for lung cancer with CT would heighten patients' anxiety and lower their quality of life but a new study published in the journal Cancer found that it's not the case.

In 2010, the National Lung Screening Trial (NLST) found that screening with helical CT scans decreases lung cancer mortality by 20 percent compared to screening with chest X-rays. For this study, the researchers at Brown University surveyed participants at 16 sites to determine the psychological effects of CT and X-ray screenings that were compared in the trial.

The participants were divided into different groups — 1,024 had false positive results, 63 had true positive results, 1,381 had true negative results and 344 had findings that weren't cancer but possibly another important medical problem.
The researchers surveyed the participants one month after their scans and then after six months. 2,317 returned the survey after one month and 1,990 returned it at six months.

The survey was composed of two standardized questionnaires to determine their physical and mental health states — the Short Form SF-36 with 36 questions and the Spielberger State Trait Anxiety Inventory with 20 questions.

They found that whether the participants received X-ray or helical CT scans, the questionnaire scores for those with false positive results were comparable to those who had true negative results. However, those who had a true positive result got worse over time because of the physical and psychological effects of the disease.

The researchers expected the participants to have increased anxiety and decreased quality of life one month after the screening, but they were pleasantly surprised that it wasn't the case. "We had anticipated that there would be a problem at one month and it would trail off at six months, which is why we measured both time points," Ilana Gareen, lead author of the study and assistant professor of epidemiology at the university, told DOTmed News. "Our findings surprised us but we were happy to see them."

They don't know for sure but they believe that the reason for that is because the participants were given a comprehensive consent form that explained that 20 to 50 percent of those screened would have a false positive result and that more work-up to ensure that they were cancer free might have been needed.

Another study was conducted at the same time as this study that qualitatively measured lung cancer risk perception. The researchers called the participants and found out that they understood that the likelihood of a false positive result and the need for additional testing are high.

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