Evaluating the Harms of Cancer Testing—A Systematic Review of the Adverse Psychological Correlates of Testing for Cancer and the Effectiveness of Interventions to Mitigate These
Abstract
:Simple Summary
Abstract
1. Introduction
Existing Research
2. Materials and Methods
2.1. Review Questions and Inclusion Criteria
2.2. Search Strategy
2.3. Study Selection
2.4. Data Extraction
2.5. Quality Assessment
2.6. Data Synthesis
3. Results
3.1. Volume of Studies
3.2. Characteristics of Included Studies (Files S1 and S2)
3.3. Quality Assessment
Clear, Focused Question | Comprehensive Search Strategy † |
|
| Validated Methods for Data Analysis | Description of Methods Included and Reproducible | |
---|---|---|---|---|---|---|
Cazacu et al., 2019 [16] | Yes | Yes | Yes | Yes | Yes | Yes |
Chad-Friedman et al., 2017 [5] | Yes | Yes | Yes | Yes | Yes | Yes |
Metsälä et al., 2011 [13] | Yes | Yes | Yes | Yes to selection NA to two reviewers | Yes | Yes |
Montgomery et al., 2010 [14] | Yes | Yes | Yes to selection NA to two reviewers | Yes to selection NA to two reviewers | Yes | Yes |
Nagendiram et al., 2018 [15] | Yes | Yes | Yes | Yes to selection NA to two reviewers | Yes | Yes |
Nelson et al., 2016 [17] | Yes | Yes | Yes | Yes | Yes | Yes |
O’Connor et al., 2016 [18] | Yes | Yes | Yes | Yes | Yes | Yes |
Van der Veld et al., 2017 [19] | Yes | Yes | Yes | Yes | Yes | Yes |
Wu et al., 2016 [20] | Yes | Yes | Yes | No | Yes | Yes |
Yang et al., 2018 [21] | Yes | Yes | Yes | Yes | Yes | Yes |
Inclusion Criteria Clearly Defined | Study Subjects and Setting Were Clearly Defined | Exposure Measured in Valid and Reliable Way | Measurement of Condition (Were Patients Selected According to Strict Definitions) | Confounders Identified | Strategies to Deal with Confounders Identified | Outcomes Measured in Valid and Reliable Way | Appropriate Statistical Analysis | |
---|---|---|---|---|---|---|---|---|
Al-Alawi et al., 2019 [22] | Yes | Yes | NA | Yes | No | No | Yes | Yes |
April-Sanders et al., 2018 [23] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
Bekkers et al., 2002 [24] | Yes | Yes | NA | Yes | No | Yes | Unclear | Yes |
Bolejko et al., 2015 [25] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
Drolet et al., 2011 [26] | Yes | Yes | NA | Yes | No | Yes | Unclear | Yes |
El Hachem et al., 2019 [27] | Yes | Yes | NA | Yes | No | Yes | Unclear | Yes |
French et al., 2006 [28] | Yes | Yes | NA | Yes | Yes | Yes | Yes | Yes |
Gray et al., 2006 [29] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
Kola et al., 2012 [30] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
Liao et al., 2008 [31] | Yes | Yes | NA | Yes | No | No | Yes | No |
Maissi et al., 2004 [32] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
Medd et al., 2005 [33] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
O’Connor et al., 2016 [34] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
Wiggins et al., 2017 [35] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
Wiggins et al., 2019 [36] | Yes | Yes | NA | Yes | No | Yes | Yes | Yes |
3.4. Synthesis of Results
4. Discussion
4.1. Summary of Findings
4.2. Strengths and Limitations of Review Methods
4.3. Clinical Implications
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author, Year | Cancer Test | Intervention (I)/ Control (C) | Measurement Tools and Assessment Timepoints | Effect Size | |
---|---|---|---|---|---|
Camail et al., 2019 [37] | Cervix Visual inspection of cervix | I: Realtime video during (N = 60) C: No realtime video (N = 58) | Measurement tools: STAI Timepoints: Pre and post procedure | mean (S.D) Intervention Control | Before: 36.4 (11.8) After: 28.5 (12.0) ∆ = −7.9 (14.3.), p-value < 0.05 Before: 33.6 (10.9) After: 29.3 (11.2) ∆ = −4.2 (9.0), p-value < 0.05 ∆I and C (before and after), p-value = 0.10 |
Chantawong et al., 2017 [38] | Cervix Loop electrosurgical excision procedure (LEEP) | I: Music (N = 74) C: No music (N = 76) | Measurement tools: VAS Timepoints: Pre and post LEEP | ∆ mean (S.D) I. Pre-biopsy II. Post-biopsy | I: 3.7 (2.6) C: 4.1 (3.0), p-value 0.38 I: 4.0 (2.9) C: 4.7 (3.2), p-value 0.16 |
Chlan et al., 2000 [39] | Colon Flexible sigmoidoscopy | I: Music during flexible sigmoidoscopy (N = 30) C: No music during flexible sigmoidoscopy (N = 34) | Measurement tools: STAI Timepoints: Pre and immediately post procedure | ∆ mean (SD) Baseline state anxiety Procedure state anxiety | I: 36.9 (12.5) C: 40.2 (11.9), p-value 0.28 I: 34.5 (10.0) C: 41.8 (13.5), p-value 0.02 |
Cruickshank et al., 2005 [40] | Cervix colposcopy | I: Self-administration of isoflurane and desflurane (N = 198) C: Self-administration of placebo (N = 198) | Measurement tools: HADS (anxiety subscale) Timepoints: - At baseline prior to treatment - Immediately posttreatment - 6 months after treatment but prior to receiving a colposcopy follow-up appointment | ∆ mean (S.D) Baseline Immediately posttreatment 6-month follow-up | I: 8.37 (4.15) C: 7.77 (3.97), p-value ‘ns’ * I: 7.30 (4.11) C: 7.29 (4.06), p-value ‘ns’ I: 6.49 (4.19) C: 6.49 (4.27), p-value ‘ns’ |
De Bie et al., 2011 [41] | Cervix Colposcopy | I: Individually targeted information (N = 75) C: Standard care (N = 74) | Measurement tools: - HADS - STAI Timepoints: Prior to colposcopy | ∆ median (IQR) STAI HADS anxiety | I: 33.0 (27.0–41.0) C: 33.0 (27.0–41.3), p-value 0.96 I: 5.0 (3.0–9.0) C: 6.0 (4.0–10.0), p-value 0.26 |
Dey et al., 2002 [43] | Breast Mammography, USS, aspiration cytology, same-day results and management plan. | I: One-stop clinics (N = 267) C: Dedicated breast clinics with women asked to return the following week to discuss the results (N = 211) | Measurement tools: - HADS (anxiety subscale) - STAI Timepoints: - Baseline (immediately before assessment) - STAI (24 hours after first visit) - HADS (three weeks and three months after diagnosis) | ∆ mean (S.D) STAI Baseline 24 hours HADS Baseline Three weeks Baseline Three months | I: 48.1 (13.9) C: 47.2 (14.9) I: 34.5 (14.6) C: 39.8 (15.8), p-value < 0.0001 I: 8.9 (4.4) C: 8.8 (4.9) I: 7.3 (4.7) C: 7.4 (4.3), p-value 0.55 I: 8.9 (4.4) C: 9.0 (5.0) I: 7.0 (4.6) C: 7.5 (4.7), p-value 0.22 |
Domar et al., 2005 [42] | Breast Mammography | I1: Listening to relaxation tape during screening mammography (N = 50) I2: Listening to music tap during screening mammography (N = 47) C: No tape (N = 46) | - STAI - Likert anxiety score Timepoints: At recruitment and immediately after mammography. | ∆ mean (SD) STAI Baseline After mammography Likert anxiety score After mammography | I1: 34.8 (9.7) I2: 33.6 (8.9) C: 33.2 (14.5), p-value 0.18 I1: 30.4 (9.3) I2: 30.9 (10.0) C: 33.2 (13.3), p-value 0.78 I1: 2.6 (1.9) I2: 3.2 (2.3) C: 2.8 (2.4), p-value 0.43 |
Ferrante et al., 2008 [44] | Breast Mammography | I: Patient navigator (N = 55) C: No patient navigator (N = 50) | Measurement tools: Zung Anxiety Self-Assessment Scale Timepoints: At enrolment and 1 month after final resolution (benign diagnosis or for cancer patients, after initiation of cancer treatment). | ∆ mean (SD) Baseline Follow-up ∆anxiety with time | I: 38.7 (13.0) C: 36.6 (9.3), p-value 0.346 I: 30.2 (7.6) C: 42.8 (13.3), p-value < 0.001 I: −8.0 (10.6) C: 5.8 (14.0), p-value < 0.001 |
Hersch et al., 2006 [45] | Breast Mammography | I: Decision aid including evidence-based information about important outcomes of breast screening compared with no screening (N = 419) C: Control decision aid which omitted all overdetection-related content but was otherwise identical (N = 419) | Measurement tools: - STAI - Structured questionnaire Timepoints: - Baseline interview 1-4 weeks after recruitment - Telephone interview 1-4 weeks after being sent decision aid | ∆ mean (SD) STAI Questionnaire Worry about breast cancer (%) - Not worried at all - A bit worried - Quite worried or very worried | I: 29·7 C: 29·6 ∆ (95% CI): 0·1 (−1.4 to 1.6), p-value 0·93 I: 42, C:32, ∆ (95% CI): 9·4 I: 51, C:55, ∆ (95% CI): −3.9 I: 7, C:13, ∆ (95% CI): -5.5 p-value 0.0026 |
Hilal et al., 2017 [46] | Cervix Colposcopy | I: Realtime video during colposcopy (N = 111) C: No realtime video during colposcopy (N = 105) | Measurement tools: - STAI - VAS Timepoints: - STAI: scores measured before (File S1) and after (File S2) colposcopy - VAS: anxiety during colposcopy | ∆ median (IQR) STAI Before colposcopy (S1) After colposcopy (File S2) ∆S (Files S1 and S2) VAS | I: 51 (42–62) C: 50 (41–61), p-value 0.73 I: 39 (33–50) C: 40 (33–48.5), p-value 0.80 I: −10.3 ± 11.3 C: −10.3 ± 11.0, p-value 0.50 I: 3 (1–5) C: 3 (1–5), p-value 0.61 |
Hilal et al., 2018 [47] | Cervix Colposcopy | I: Music during colposcopy (N = 103) C: No music during colposcopy (N = 102) | Measurement tools: - STAI - VAS Timepoints: STAI: scores measured before (File S1) and after (File S2) colposcopy VAS: anxiety during colposcopy | ∆ median (IQR) STAI Before colposcopy (S1) After colposcopy (File S2) ∆S (Files S1 and S2) VAS | I: 48 (42–59) C: 50 (41–59.25), p-value 0.91 I: 40 (33–47) C: 439 (32.75–46), p-value 0.92 I: −9.4 ± 10.8 C: −9.0 ± 10.6, p-value 0.40 I: 2 (1–5) C: 2 (1–6), p-value 0.28 |
Lang et al., 2006 [48] | Breast Large core needle biosy | I1: Self-hypnotic relaxation (N = 78) I2: Empathic Attention (N = 82) C: Standard of care (N = 76) | Measurement tools: - Anxiety on VAS of 0–10 (t = 0 to t = 110 minutes) - STAI Timepoints: - Baseline anxiety - Self-rating anxiety every 10minutes in procedure room | Significant increase in anxiety in control No change in empathy group Significant decrease in hypnosis group | logit slope = 0.18, p < 0.001 logit slope = −0.04, p = 0.45 logit slope = −0.27, p < 0.001 |
Shaik et al., 2010 [49] | Colorectal Colonoscopy | I: Information aid including American Gastroenterological Association colonoscopy educational pamphlet along with prep instructions (N = 51) C: Standard preparationinstructions only (N = 55) | Measurement tools: STAI Timepoints: Immediately before colonoscopy | ∆ mean STAI Medication usage Midazolam (reduces anxiety) Meperidine (reduces pain) | I: 40.54 C: 45.18, p-value 0.0146 I: 2.35 C: 2.9, p-value 0.0444 I: 73.03 C: 76.81, p-value 0.374 |
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Kwong, F.L.; Davenport, C.; Sundar, S. Evaluating the Harms of Cancer Testing—A Systematic Review of the Adverse Psychological Correlates of Testing for Cancer and the Effectiveness of Interventions to Mitigate These. Cancers 2023, 15, 3335. https://doi.org/10.3390/cancers15133335
Kwong FL, Davenport C, Sundar S. Evaluating the Harms of Cancer Testing—A Systematic Review of the Adverse Psychological Correlates of Testing for Cancer and the Effectiveness of Interventions to Mitigate These. Cancers. 2023; 15(13):3335. https://doi.org/10.3390/cancers15133335
Chicago/Turabian StyleKwong, Fong Lien, Clare Davenport, and Sudha Sundar. 2023. "Evaluating the Harms of Cancer Testing—A Systematic Review of the Adverse Psychological Correlates of Testing for Cancer and the Effectiveness of Interventions to Mitigate These" Cancers 15, no. 13: 3335. https://doi.org/10.3390/cancers15133335