HOW DISTRESSING IS ATTENDANCE FOR ROUTINE BREAST SCREENING

A prospective cohort study of 2357 women eligible for participation in the UK National Breast Screening Programme was carried out to evaluat e the immediate emotional and behavioural effects of attending for rou tine mammography. Women completed the Hospital Anxiety and Depression Scale (HADS) in the context of a survey by their General Practitioner before they knew they were to receive an invitation to attend screenin g and again at screening some 6 weeks later. In addition, an ad hoc He alth Questionnaire was administered when the women attended for screen ing to assess possible self-perceived stress-related behaviour changes in the previous week. 2110 (89.5% response rate) women returned the i nitial postal baseline HADS and 1635 completed the HADS again at scree ning. Anxiety and depression scales were significantly lower at screen ing than at baseline (t = 3.16, p < 0.002, 95% CI = 0.07 to 0.31) and (t = 8.46, p < 0.0001, 95% CI = 0.32 to 0.52) respectively. Women scor ing in the borderline range at baseline were more likely to move into the normal than the clinically significant range for anxiety (chi2 = 4 0.36, p < 0.001) and also for depression (chi2 = 56.04, p < 0.001), an d women scoring in the clinically significant range for anxiety were m ore likely to become normal than vice versa (chi2 = 5.95, p < 0.02). T he Health Questionnaire indicated that some women reported stress-rela ted behaviour changes in the week prior to screening, especially those who were most anxious or depressed.