Background/Aims Colorectal cancer (CRC) screening reduces morbidity and mortality. It is important to understand the effect of a positive fecal occult blood (FOB) screening test result on mental health and general well-being. The goal of this study is to evaluate differences in colon cancer worry, general anxiety and perceived health status among individuals receiving FOBT(+) and FOBT (−) results at 7-14 days and 4 months post screening. The study is the first to simultaneously chart mental and physical well-being associated with CRC screening. Methods Of 2,263 eligible Group Health Cooperative members participating in a CRC screening study, 1,513 completed baseline surveys and returned FOBT screening kits. FOBT(+) patients (n=55) were matched on age and gender with FOBT (−) patients (n=110), and both groups were asked to complete follow-up surveys at 7-14 days and 4-months post FOB testing. We assessed general anxiety using the General Health Questionnaire (GHQ)-12; CRC worry frequency and mood disturbance attributed to CRC worry using binary indicators of these outcomes; and perceived health status using a quality of life tool. Results Mean respondent age was 59 years, most were women (63%), with college degrees (42%), and employed full/part-time (65%). After adjusting for age, gender and baseline worry, FOBT (+) group was at a higher risk than FOBT (−) for frequent CRC worry at 7-14 days post test result (RR=1.87, 95% CI: 1.03, 3.38), (p=0.04), with the proportion of CRC worry doubling from baseline to 7-14 days post (18.18% to 36.36%), then returning to baseline levels at 4 months post. The FOBT(+) group was more likely to report disturbances in mood associated with recent CRC thoughts at 7-14 days (RR=5.58, 95% CI: 1.86, 16.74), (p=0.002), and mood disturbances increased four-fold from baseline to 7-14 days post (5.45% to 22.73%), then declined to baseline levels by 4 months post. We did not observe significant group differences in general anxiety or perceived health status. Discussion Receipt of a positive FOBT result is associated with elevated colon cancer worry and mood disturbances immediately following FOB test, however, respondents demonstrated recovery from cancer worry by four months after receiving the result.
Available at: http://works.bepress.com/sharon-laing/5/