Psychosocial consequences of receiving false-positive colorectal cancer screening results: a qualitative study

Abstract

Objective: The objective of this study was to investigate the psychosocial consequences of receiving false-positive colorectal cancer (CRC) screening results, following a positive immunochemical faecal occult blood test.

Design, setting, and subjects: We conducted a qualitative study with four semi-structured focus group interviews with 16 participants aged 50–74, all of whom had received a false-positive result in the national Danish CRC screening programme. We selected, recruited, and grouped participants to ensure maximum variation, and to enable a level of confidence to speak openly about experiences of screening. We subjected interview data, audio-recordings, and transcripts to a strategy of qualitative analysis called systematic text condensation.

Results: We identified four main themes which described the psychosocial consequences of false-positive CRC screening results: anxiety; discomfort; changed self-perception and behaviour; and considerations on participation in screening. Each of these themes covered a wide range of experiences which were relevant to the informants and broadly shared by them in many aspects.

Conclusions: Receiving false-positive results from CRC screening can lead to negative psychosocial consequences such as changes in self-perception and anxiety: some participants may experience subsequent relief, others not. These negative psychosocial consequences might persist over time.

Implications: Negative psychosocial consequences from false-positive CRC screening results may result in a greater use of general practitioner services by healthy people who need reassurance or further tests. More research using condition-specific measures is required to further understand the degree and potential persistence of psychosocial consequences of false-positive results from CRC screening.

Key Points

• Participants who receive false-positive colorectal cancer (CRC) screening results may experience negative psychosocial consequences e.g. anxiety and subsequent relief.

• Participants who receive false-positive CRC screening results may experience discomfort during the screening process.

• Participants who receive false-positive CRC screening results may experience longer term changes of self-perception.

• Participants who receive false-positive CRC screening results may experience ambivalence about the offered diagnostic down-stream procedures including colonoscopy.

Keywords:

• Colorectal cancer
• mass screening
• colonoscopy
• immunochemical faecal occult blood test
• qualitative research
• psychosocial consequences
• harms

Acknowledgements

We thank the 16 individuals who participated in this study and the Danish College of General Practitioners for their financial support. We also thank our research colleagues Lennart Friis-Hansen and Jonathan Comins for their valuable contributions to this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The project was funded by the PLU-foundation administered by The Danish College of General Practitioners.

According to Danish law it is not necessary to report qualitative research projects to the Danish Data Protection Agency or the local committee of research ethics if informants’ identities are kept anonymous.