Psychological Impact of Screening for Disease

It is obvious that screening for some diseases can have a serious impact on people’s psychological well-being. An example is screening for the universally fatal condition Huntington’s disease. This is a condition that appears first in adult life and inexorably leads to mental and physical decline and death. Genetic screening for this disease is possible before onset but is not available to patients until they have had genetic counselling first so they fully understand the impact of having screening done and possibly getting a positive result.

There is a widely held expectation that screening for disease has adverse emotional impacts regardless of the types of diseases being screened for. Researchers in the UK wondered about what people think about screening for more common diseases that usually have a less significant impact even though they may cause death in the long term. They retrieved studies published since 1950 that examined this question. Of the 12 studies that met the inclusion criteria, six involved screening for cancer, two for diabetes, and one each for abdominal aortic aneurysms, peptic ulcer, coronary heart disease and osteoporosis. Five studies reported data on anxiety, four on depression, two on general distress and eight on quality of life assessed between one week and 13 years after screening.

Meta-analyses combining the results from all these studies showed somewhat surprisingly that there was no significant impact of screening on longer term anxiety, depression or quality of life. This was true regardless of whether the subjects had tested positive or negative for disease risk or disease presence. The conclusion of the researchers was that screening does not appear to have adverse emotional impacts in the longer term (> 4 weeks). Too few studies assessed outcomes before four weeks to comment on the shorter term emotional impact of screening.

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