Did psychosocial status, sociodemographics and smoking status affect non-attendance in control participants in the Danish Lung Cancer Screening Trial? A nested observational study
Menée au Danemark à partir d'une enquête auprès de 2 052 fumeurs ou anciens fumeurs inclus dans un essai évaluant deux modalités de dépistage du cancer du poumon et invités à participer à 5 sessions d'examens cliniques de dépistage, cette étude analyse l'effet du statut psychosocial, des caractéristiques sociodémographiques et du statut tabagique sur la participation aux trois premières sessions de dépistage
Objectives : We investigated if psychosocial status, sociodemographics and smoking status affected non-attendance in the control group in the randomised Danish Lung Cancer Screening Trial (DLCST).
Design and setting : This study was an observational study nested in the DLCST. Due to large non-attendance in the control group in the second screening round we made an additional effort to collect questionnaire data from non-attenders in this group in the third screening round. We used a condition-specific questionnaire to assess psychosocial status. We analysed the differences in psychosocial status in the third and preceding rounds between non-attenders and attenders in the control group in multivariable linear regression models adjusted for sociodemographics and smoking status reported at baseline. Differences in sociodemographics and smoking status were analysed with
χ2 tests (categorical variables) and t-tests (continuous variables).
Primary outcome measure
:
Primary outcome was psychosocial status.
Participants
:
All control persons participating in the third screening round in the DLCST were included.
Results
:
Non-attenders in the third round had significantly worse psychosocial status than attenders in the scales: ‘behaviour’ 0.77 (99% CI 0.18 to 1.36), ‘self-blame’ 0.59 (99% CI 0.14 to 1.04), ‘focus on airway symptoms’ 0.22 (99% CI 0.08 to 0.36), ‘stigmatisation’ 0.51 (99% CI 0.16 to 0.86), ‘introvert’ 0.56 (99% CI 0.23 to 0.89) and ‘harms of smoking’ 0.35 (99% CI 0.11 to 0.59). Moreover, non-attenders had worse scores than attendees in the preceding screening rounds. Non-attenders also reported worse sociodemographics at baseline.
Conclusions
:
Non-attenders had a significantly worse psychosocial status and worse sociodemographics compared with attenders. The results of our study contribute with evidence of non-response and attrition driven by psychosocial status, which in turn may be influenced by the screening intervention itself. This can be used to adjust cancer screening trial results for bias due to differential non-attendance.
BMJ Open , article en libre accès, 2019