open access: Psychological distress in newly diagnosed colorectal cancer patients following microsatellite instability testing for Lynch syndrome on the pathologist’s initiative

Psychological distress in newly diagnosed colorectal cancer patients following microsatellite instability testing for Lynch syndrome on the pathologist’s initiative

"....One limitation of our study was the low response rate in the eligible patients. This may have biased our results, especially if the surgeons had consciously avoided recruiting patients with a (very) poor prognosis or emotional problems. Such bias would have resulted in underestimation of psychological distress. At present, we cannot assess whether bias was present. However, we note that in our sample, the levels of psychological distress were lower than those described in the literature. 

Another reason for the low response rate may have been the complex logistic inclusion procedure [15], if communication of the test result to the patient exceeded the inclusion criterion of 6 months. In some cases, it took several months before the MSI-test report, written by the pathologist, was sent to the surgeon and a number of weeks more before the patient was contacted. Another limitation of our study was that no firm conclusions could be drawn, because the large number of tests increased the possibility of a type I error, which we have not corrected for. 

Despite some methodological concerns, we can conclude that moderate levels of distress were present following MSI testing in patients recently diagnosed with CRC. These levels were similar to those in other patients diagnosed with CRC [27, 47, 48]. 

High cancer-specific distress was observed in 40% of the MSI-positive patients and was significantly correlated with female gender."