Abstract

Behavioral oncology research has suggested that participation in population-based cancer screening programs may be more stressful than previously thought. The purpose of the present study was to examine quality of life, general distress, and cancer-specific distress among participants in an ovarian cancer screening program. The Short Form 36, Brief Profile of Mood States, and Revised Impact of Events Scale (cued to risk of ovarian cancer) measured quality of life, general distress, and ovarian cancer-specific distress, respectively. For comparison purposes, data were collected from a sample of age- and education-matched non-participants. Respondents included 102 female participants in an ovarian cancer screening program (SG) and 102 matched controls (MC). Respondents were predominantly Caucasian (97%), married (58%), high school educated (25%), and were an average age of 54 years (SD = 14). Non-screening group members were significantly more likely to be a racial minority (p<.05) and were less likely to be married (p<.05). Results revealed that SG respondents reported significantly higher ovarian cancer distress (p<.05) and avoidance (p<.05); however, there were no differences between the two groups on measures of quality of life and general distress. Approximately 5 to 10% of SG respondents reported levels of distress indicating a potential need for further evaluation and raising concerns about vulnerability to adverse screening outcomes (i.e., future noncompliance with screening guidelines or increased cancer distress). These results provide qualified support for the hypothesis that cancer screening is a psychologically-active experience and suggest a need for additional research in the area of psychological and behavioral responses to cancer screening.

Introduction

Background

• Behavioral oncology research has suggested that participation in cancer screening is not without psychological consequences.
  
• Some participants may experience clinically significant levels of distress related to their risk of cancer or their participation in cancer screening.
  
• For example, some people experience substantial distress following false positive cancer screening results.

Purpose and Hypotheses

• The primary aim of the current study was to examine quality of life, general psychological distress, and cancer-specific distress among women undergoing a population-based ovarian screening.
• We hypothesized that ovarian screening participants would: (1) report significantly higher cancer-specific distress; (2) but not higher general psychological distress; or (3) lower health-related quality of life than a group of sex, age, and education matched non-participants.

Method

Procedure

• Sample
  
• Screening Group (SG)
  
• 102 women prior to transvaginal ultrasound screening
  
• Matched Control Group (MC)
  
• 102 sex, age and education matched controls from community
  
• Questionnaire Survey
  
• 25-45 minute survey administration

Measures

• Health–Related Quality of Life (HR-QOL)
  
• Short Form – 36 (SF-36)
  
• General Distress
  
• Brief Profile of Mood States (B-POMS)
  
• Ovarian Cancer-Specific Distress
  
• Impact of Events Scale – Revised

Sample Description

• Respondent Characteristics
  
• 102 participants in an ovarian cancer screening program (SG)
  
• 102 matched controls (MC)
  
• Predominantly Caucasian (97%)
  
• Married (58%)
  
• High school educated (25%)
  
• Average age of 54 years (SD = 14)
  
• Group Comparison (SG vs. MC)
  
• MC significantly more likely to be a racial minority (p < .05)
  
• MC significantly less likely to be married (p < .05)
  
• No other group differences were identified.
  

Results

Psychological Adjustment

Group Mean Raw Scores

OC Distress
Screening Group
Matched Group
p < .05

OC Avoidance
Screening Group
Matched Group
p < .05

OC Intrusion
Screening Group
Matched Group
p < .10

General Distress
Screening Group
Matched Group

Health-Related Quality of Life
Group Mean T-scores

SFPF
Screening Group
Matched Group

SFRP
Screening Group
Matched Group

SFBP
Screening Group
Matched Group

SFGH
Screening Group
Matched Group

SF-V SFSF
Screening Group
Matched Group

SFRE
Screening Group
Matched Group

SFMH
Screening Group
Matched Group

Screening Group Clinical Data

General Distress (B-POMS)
– 12% scored 15 or above
– 4% scored 30 or above

Ovarian Cancer-Specific Distress (IES-R-Total)
– 15% scored 15 or above
– 8% scored above 30

Ovarian Cancer-Specific Avoidance (IES-R-A)
– 20% scored 8 or above
– 11% scored 15 or above

Ovarian Cancer-Specific Intrusion (IES-R-I)
– 12% scored 8 or above
– 4% scored 15 or above

Discussion

Summary of Results

• SG participants reported significantly higher ovarian cancer-specific distress than MC participants.
  
• SG and MC participants reported similar levels of health-related quality of life and general psychological distress
  
• Approximately 5 – 10% of SG participants reported clinically significant levels of psychological distress.
  

Conclusions

• These results provide qualified support for the hypothesis that cancer screening is a psychologically-active experience.
  
• However, there is an ongoing need for additional research in the area of psychological and behavioral responses to cancer screening and the utility of interventions to promote health adjustment among program participants.