CT-Screening for lung cancer does not increase the use of anxiolytic or antidepressant medication

BMC Cancer. 2012 May 23:12:188. doi: 10.1186/1471-2407-12-188.

Abstract

Background: CT screening for lung cancer has recently been shown to reduce lung cancer mortality, but screening may have adverse mental health effects. We calculated risk ratios for prescription of anti-depressive (AD) or anxiolytic (AX) medication redeemed at Danish pharmacies for participants in The Danish Lung Cancer Screening Trial (DLCST).

Methods: The DLCST was a randomized clinical trial which comprised 4,104 former or present smokers who were randomized from 12 May 2004 to 20 June 2006 to either CT scan of the chest, lung-function test and filling in questionnaires annually for five years in the period 1 April 2006-31 March 2010 (n = 2,052), or to a control group (n = 2,052) receiving similar procedures except CT scan. We used CT scan intervention group versus control group status as exposure. The follow-up period for use of AD or AX was three years. Baseline data on civil status, socioeconomic status, and co-morbidity as well as outcome data on AD and AX were obtained by linkage to national registries.

Results: The intervention and the control groups did not differ by age, gender, civil status, socio-economic position, co-morbidity index or former use of AD or AX. The adjusted risk ratio for at least one recipe of AD or AX in the CT intervention group during follow-up was not increased when adjusting for previous use of AD or AX, HR 1.00, 95 % CI (0.90-1.12). Similar results were seen when excluding subjects using AD or AX in a four-month or two-year period before baseline, when analyzing AD and AX separately, or requiring at least two recipes.

Conclusions: We found no indications that participation in a lung cancer CT-screening program increases the risk of specific adverse mental health outcomes.

Trial registration: Clinical Trials.gov Protocol Registration System (NCT00496977).

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Anxiety Agents* / therapeutic use
  • Antidepressive Agents* / therapeutic use
  • Anxiety / drug therapy
  • Comorbidity
  • Depression / drug therapy
  • Drug Utilization*
  • Early Detection of Cancer / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / epidemiology
  • Male
  • Mass Screening / psychology
  • Middle Aged
  • Risk
  • Tomography, X-Ray Computed*

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents

Associated data

  • ClinicalTrials.gov/NCT00496977