Purpose: Lung cancer screening results in a high rate (30-40%) of “indeterminate” findings, which may lead to anxiety or non-recommended health care utilization for individuals with such a results. Because lung cancer screening has not yet been shown to be efficacious in reducing mortality, the psychological and financial consequences of screening for lung cancer should be taken into account in decisions about screening. We examined several quality of life outcomes over time to determine the effect of various screening results on patients screening for lung cancer.

Methods: 400 individuals participating in a lung cancer screening efficacy study were recruited to complete 4 surveys: one at baseline before screening, one immediately after screening results were known, and at 6 and 12 months after screening. General well being, perceived risk of lung cancer, and anxiety were measured. From screening results, individuals were classified as having negative (category 1), indeterminate (category 3), or suspicious results (category 4).

Results: 169 males and 161 females completed all surveys; 95% were Caucasian. Participants' mean age was 60 years, and the average duration of smoking was 41 years. Between baseline and immediately after screening, individuals in categories 3 and 4 had significantly lower current general health ratings, higher cancer worry and higher state anxiety. Individuals in category 4 also had significantly higher perceived risk of lung cancer. At 12 months, general health ratings remained lower than baseline for category 4 individuals. State anxiety dropped to baseline levels at 6 months for category 4 individuals and at 12 months for category 3 individuals. Perceived risk of lung cancer at 12 months was not significantly different from baseline.

Conclusions: All individuals screened for lung cancer have inflated perceived risks of having lung cancer, and these risk are not adjusted adequately with screening results. In addition, screening results in lower general health perception and higher anxiety. However, these results most disappear for all screened individuals by 12 months. Individuals with an “indeterminate” screen, where the recommended follow up is a 12 month additional screen, remain anxious longer than those with a suspicious screen who might be receiving earlier follow up care.