Psychosocial factors associated with withdrawal from the United Kingdom collaborative trial of ovarian cancer screening after 1 episode of repeat screening

Jenkins, Valerie, Fallowfield, Lesley, Langridge, Carolyn, Barrett, Jessica, Ryan, Andy, Jacobs, Ian, Kilkerr, Justine, Menon, Usha and Farewell, Vernon (2015) Psychosocial factors associated with withdrawal from the United Kingdom collaborative trial of ovarian cancer screening after 1 episode of repeat screening. International Journal Of Gynecological Cancer, 25 (8). pp. 1519-1525. ISSN 1048-891X

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Abstract

Objective: The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) aims to establish the efficacy of 2 different ovarian cancer screening schedules. The psychosocial substudy examines the psychological factors associated with the screening program.

Methods: Women aged 50 to 75 years from 16 UK gynecologic centers randomized to annual multimodal screening or ultrasound screening (US) groups were followed up for 7 years. Psychosocial data from women who withdrew from the study after a repeat screen were examined.

Results: Sixteen percent (3499/21,733) of women requiring a repeat screening test in addition to annual screen withdrew from the study: 12.9% (1560/12,073) from the multimodal group and 20.1% (1939/9660) from the US group. An estimated relative risk of withdrawal is 1.46 (95% confidence interval, 1.36-1.56; P <= 0.001) for the US arm. High anxiety trait and increased psychological morbidity significantly influenced withdrawal, even when age, screening center, and group were taken into account (P < 0.001). The risk of withdrawal decreased significantly the longer a woman stayed in UKCTOCS, irrespective of the number of screens and intensity in the preceding year.

Conclusions: Withdrawal rate was greater in women undergoing US screening and in those who had repeats earlier in UKCTOCS. Having a high predisposition to anxiety, high current state anxiety, and above threshold general psychological morbidity all increased the withdrawal rate.

Item Type: Article
Keywords: Ovarian cancer; population screening programme; withdrawal; anxiety; psychological morbidity; UKCTOCS
Schools and Departments: Brighton and Sussex Medical School > Sussex Health Outcomes Research & Education in Cancer (SHORE-C)
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology Including cancer and carcinogens
Depositing User: Kathryn Monson
Date Deposited: 22 Jul 2015 14:21
Last Modified: 15 Mar 2017 03:20
URI: http://sro.sussex.ac.uk/id/eprint/55675

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Project NameSussex Project NumberFunderFunder Ref
UKCTOCSRQ01-G0543Medical Research CouncilG9901012
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