Short-term psychosocial outcomes of adding a non-contrast abdominal CT scan to the thoracic CT within lung cancer screening
Objectives: To evaluate psychological, social and financial outcomes among individuals undergoing a non-contrast abdominal CT scan to screen for kidney cancer and other abdominal malignancies alongside the thoracic CT within lung cancer screening.
Subjects and methods: The Yorkshire Kidney Screening Trial (YKST) is a feasibility study of adding a non-contrast abdominal CT scan to the thoracic CT within lung cancer screening. 500 participants within YKST, comprising all who had an abnormal CT scan and a random sample of one-third of those with a normal scan between 14/3/2022-24/08/2022 were sent a questionnaire at three- and six-months. Outcomes included the Psychological Consequences Questionnaire (PCQ), the Short-form of the Spielberger State Trait Anxiety Inventory and the EQ-5D-5L. Data were analysed using regression adjusting for participant age, sex, socioeconomic status, education, baseline quality of life (EQ-5D) and ethnicity.
Results: 380 (76%) participants returned questionnaires at three-months and 328 (66%) at six-months. There was no difference in any outcomes between participants with a normal scan and those with abnormal scans requiring no further action. Individuals requiring initial further investigations or referral had higher scores on the negative PCQ than those with normal scans at three months (difference 0.28 SD (95% CI 0.01-0.54), p=0.044). The difference was greater in those with anxiety or depression at baseline. No differences were seen at six months.
Conclusion: Screening for kidney cancer and other abdominal malignancies using abdominal CT alongside the thoracic CT within lung cancer screening is unlikely to cause significant lasting psychosocial or financial harm to participants with incidental findings.