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Psychosocial factors associated with withdrawal from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) following one episode of repeat screening
Abstract:
Objective: The
United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS)
aims to establish the efficacy of two different ovarian cancer
screening schedules. The psychosocial sub study examines the
psychological factors associated with the screening programme.
Methods: Women aged 50 to 75 years from 16 UK gynaecological centres
randomised to annual multimodal screening (MM), or ultrasound screening
(US) groups were followed for seven years. Psychosocial data from women
who withdrew from the study following a repeat screen were examined.
Results: 16% (3499/21733) of women requiring a repeat screening test in
addition to annual screen withdrew from the study; 12.9% (1560/12073)
from the MM group, and 20.1% (1939/9660) from the US group; an estimated
relative risk of withdrawal of 1.46 (95%CI: [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 centre,
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.
Description:
This is the author accepted manuscript. It is currently under an indefinite embargo pending publication of the final version.
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