OBJECTIVES

: Multi-cancer early detection tests are currently being developed to enable earlier detection of multiple cancer types. As reflected in patient-reported outcomes (PROs), the psychosocial impact of existing single-cancer screenings is unknown. Our aim is to evaluate the impact of primary cancer screening on PROs.

METHODS

: A systematic review was conducted using MEDLINE, EMBASE, and reference lists of articles from January 2000 to August 2020 for relevant publications assessing the psychosocial impact of primary cancer screening before and after the screening process (up to 1 year), including after receiving abnormal results. Studies with patients undergoing only secondary screening or diagnostic evaluation, or with active cancer, were excluded.

RESULTS

: A total of 31 studies were included, and reflected PRO assessments associated with lung, breast, colorectal, anal, ovarian, cervical, prostate, and pancreatic cancer screening procedures. Anxiety was the most commonly assessed construct, using the State-Trait Anxiety Inventory. Cancer-specific distress and health-related quality of life (HRQOL) were also assessed using a broad range of validated and unvalidated measures. Overall, individuals tolerated screening procedures well with no major psychosocial effects. Of note, higher levels of anxiety, distress, and worry were present while waiting for screening results and following indeterminate results that required further testing, which also decreased individuals’ HRQOL. These negative psychosocial effects were, however, not long-lasting and returned to baseline, typically by 1 year. Furthermore, individuals with higher cancer risk, including current smokers and those with a family or personal history of cancer, tended to have higher levels of anxiety and distress throughout the screening process, even after receiving results.

CONCLUSIONS

: The psychosocial impact of cancer screening is relatively low overall and short-lived, but can be significant. Individuals with a higher risk of cancer tend to experience more anxiety and distress during the screening process; thus, more attention to this group is recommended.