The psychologic effect of attending a screening program for colorectal polyps

Background: Participation in screening programs for malignant disease may h ave negative psychologic health effects that could outweigh the beneficial effects of the screening itself The present study was designed to investiga te the psychologic effect of attending a screening program for detection an d removal of colorectal adenomas, which are precursors to colorectal cancer . Method: In 1983 a prospective, controlled screening study using flexible sigmoidoscopy to detect adenomas was started in Telemark County, Norway. Fo ur hundred individuals were enrolled as a screening group and 399 as a cont rol group. In 1996 survivors in both groups were invited to have a colonosc opic screening examination for detection and removal of polyps. Four hundre d and fifty-one individuals (71 %) attended; their mean age was 67.2 years (range, 63-72 years), and 48 % were women. Fourteen days and 3 and 17 month s after the examination the attendees received by mail a questionnaire comp osed of Goldberg's General Health Questionnaire (GHQ-28) and the Hospital A nxiety and Depression Scale (HADS). The questionnaire was also mailed to an age- and sex-matched group not enrolled in the endoscopic screening study. Four hundred and nine (95 %), 395 (92 %), and 389 (91 %), respectively, re turned the questionnaire. Of the controls 314 (70 %) returned filled-in que stionnaires. Results: The scores for both GHQ-28 and HADS were lower, indic ating a lower level of psychiatric morbidity among those attending the exam ination in 1996 than among the controls. There was a trend towards higher s cores with increasing time after the examination in the screened group. Con clusion: During the first 17 months after screening the attendees, as a gro up, did not appear to have developed untoward psychologic effects as judged by HADS and GHQ questionnaires.