Skip to main content Accessibility help
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 1
  • Print publication year: 2004
  • Online publication date: December 2009

10 - Short-term outcomes of chemoprevention, genetic susceptibility testing, and screening interventions: What are they? How are they measured? When should they be measured?



Cancer is a frequent and serious illness with major impact on the quantity and quality of life. For several common cancers, preventive measures and periodic screening can reduce the risk for cancer incidence or, through early detection, lower morbidity and mortality from incident cancers. More recently, genetic testing has been introduced to screen for cancer susceptibility mutations. Presumably, the benefits of screening and early detection are accompanied by net improvements in the quality of life for persons in whom cancers are prevented or detected early. However, both prevention efforts and screening also have the potential to influence quality of life more subtly, either positively or negatively, for the large majority of asymptomatic individuals who would never have developed the cancer.

Faced with an increasing number of effective prevention and screening strategies and technologies, individual patients, health care systems, and policy analysts need accurate assessments of quality-of-life outcomes to inform shared decision making and to conduct relevant decision and cost-effectiveness analyses.– However, there has been little research on short-term effects on quality of life, which may be the predominant effects of chemopreventive or screening interventions.

In this chapter, short-term outcomes are defined, a framework for understanding and measuring these outcomes presented, the quality-of-life domains most relevant to cancer prevention and screening activities explored, the existing literature and tools currently employed to measure outcomes reviewed, methodological challenges highlighted, and recommendations for future studies made.

Related content

Powered by UNSILO
Strain, J. J. (1990). The evolution of quality of life evaluations in cancer therapyOncology 4:22–7
Heithoff, K. A. (1990). Effectiveness and Outcomes in Health Care: Proceedings of an Invitational Conference by the Institute of Medicine, Division of Health Care Services. Washington, DC: National Academy Press
Holland, J. C. (1986). Assessment of Quality of Life and Cancer Treatment. Brookline, MA: Cancer and Leukemia Group B (CALGB)
Mandelblatt, J., Armetta, C., Yabroff, al. (2004). A descriptive review of the literature on breast cancer outcomes:1990–2000Journal of the National Cancer Institute, in press
Patrick, D. L., Erickson, P. (1993). Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation. New York, NY: Oxford University Press
Johnston, K., Brown, J., Gerard, al. (1998). Valuing temporary and chronic health states associated with breast screeningSocial Science and Medicine 47(2):213–22
Dickersin, K. (1994). Identifying relevant studies for systematic reviewsBritish Medical Journal 309:1286–91
Greenwald, P. (2001). From carcinogenesis to clinical interventions for cancer preventionToxicology 166:37–45
Osborne, M., Boyle, P., Lipkin, M. (1997). Cancer preventionLancet 2(Suppl.):27–30
Moinpour, C., Lovato, L., Thompson, I., Ware, al. (2000). Profile of men randomized to the prostate cancer prevention trial: baseline health-related quality of life, urinary and sexual functioning and health behaviorsJournal of Clinical Oncology 18(1942):1953
Fallowfield, L., Fleissig, A., Edwards, al. (2001). Tamoxifen for the prevention of breast cancer: psychosocial impact on women participating in two randomized controlled trialsJournal of Clinical Oncology 19(7):1885–92
Ganz, P. A., Day, R., Ware, J. al. (1995). Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention TrialJournal of the National Cancer Institute 87(18):1372–82
Stewart, A. L., Ware, J. E. (eds) (1992). Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press
Goldberg, D. P., Hillier, V. F. (1979) A scaled version of the General Health QuestionnairePsychology Medicine 9(1):139–45
Spielberger, C. D. (1983). Manual for the State-Trait Anxiety Inventory STAI(form Y) “Self evaluation questionnaire.” Palo Alto, CA: Consulting Psychologists Press
Wallston, K. A. (1978). Development of the Multidimensional Health Locus of Control (MHLC) ScalesHealth Education Monograph 6(2):160–70
Andresen, E. M., Malmgren, J. A., Carter, W. al.Screening of depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale)American Journal of Preventive Medicine 10:77–84
Barry, M. J. (1995). Measuring disease-specific health status in men with benign prostatic hyperplasia. Measurement Committee of the American Urological AssociationMedical Care 33(4(Suppl.)):AS145–55
Barry, M. J., Fowler, F. J., O'Leary, M. al. (1992). The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological AssociationJournal of Urology 148(5):1549–57
Sherbourne, C. D. (1992). Social functioning: sexual problems measures. In Measuring Functioning and Well-being: The Medical Outcomes Study Approach, eds. A. L. Stewart, J. E. Ware, Jr., pp. 194–204. Durham, NC: Duke University Press
Thirlaway, K. (1996). The Sexual Activity Questionnaire: a measure of women's sexual functioningQuality of Life Research 5(1):81–90
Hunter, M. (1992). The Women's Health Questionnaire. A measure of mid-aged women's perceptions of their emotional and physical healthPsychology and Health 7:15–54
Strickler, R. (2000). Raloxifene and estrogen effects on quality of life in healthy postmenopausal women: a placebo-controlled randomized trialObstetrics and Gynecology 96(3):359–65
Epstein, R. S., Deverka, P. A., Chute, C. al. (1992). Validation of new quality of life questionnaire for benign prostatic hyperplasiaJournal of Clinical Epidemiology 45:1431–45
Hudmon, K., Lover, R., Chamberlain, R. (1999). Perceived benefits and barriers to participation in a phase I/II colon cancer prevention trialJournal of Cancer Education 14:83–7
Day, R., Ganz, P. A., Costantino, J. al. (1999). Health-related quality of life and tamoxifen in breast cancer prevention: a report from the National Surgical Adjuvant Breast and Bowel Project P-1 StudyJournal of Clinical Oncology 17(9):2659–69
Thirlaway, K., Fallowfield, L., Cuzick, J. (1996). Anxiety in women “at risk” of developing breast cancerBritish Journal of Cancer 73:1422–4
Cummings, S. R., Eckert, S., Krueger, K. al. (1999). The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene EvaluationJournal of the American Medical Association 281(23):2189–97
Fisher, B., Costantino, J. P., Wickerham, D. al. (1998). Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 StudyJournal of the National Cancer Institute 90(18):1371–88
Ware, J. E., Sherbourne, C. D.Jr. (1992). The MOS 36-item short-form health survey (SF-36): Conceptual framework and item selectionMedical Care 30(6):473–81
Roberts, R. E., Vernon, S. W. (1983). The center for epidemiologic studies depression scale: Its use in a community sampleAmerican Journal of Psychiatry 140(1):41–6
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general populationApplied Psychological Measurement 1:385–401
Dunn, B. K., Ford, L. G. (2001). From adjuvant therapy to breast cancer prevention: BCPT and STARBreast Journal 7(3):144–57
Levine, M., Moutquin, J. M., Walton, al. (2001). Chemoprevention of breast cancer. A joint guideline from the Canadian Task Force on Preventive Health Care and the Canadian Breast Cancer Initiative's Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast CancerCanadian Medical Association Journal 164(12):1681–90
Fabian, C. J. (2001). Breast cancer chemoprevention: beyond tamoxifenBreast Cancer Research 3(2):99–103
Thompson, I. M. J., Kouril, M., Klein, E. al. (2001). The prostate cancer prevention trial: current status and lessons learnedUrology 57(4 (Suppl.)):230–4
Kaplan, S., Garvin, D., Gilhooly, al. (2000). Impact of baseline symptom severity on future risk of benign prostatic hyperplasia-related outcomes and long-term response to finasterideUrology 56(4):610–16
Clark, L. C., Dalkin, B., Krongrad, al. (1998). Decreased incidence of prostate cancer with selenium supplementation: results of a double-blind cancer prevention trialBritish Journal of Urology 81:730–4
Clark, L. C., Combs, G. F., Turnbull, B. al. (1996). Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study GroupJournal of the American Medical Association 276:1957–63
Kazis, L. E., Ren, X. S., Lee, al. (1999). Health status in VA patients: results from the Veterans Health StudyAmerican Journal of Medical Quality 14(1):28–38
Baron, J. A. (2000). Nonsteroidal anti-inflammatory drugs and cancer preventionAnnual Review of Medicine 51:511–23
Kune, G. A. (1988). Colorectal cancer risk, chronic illnesses, operations, and medications: case control results from the Melbourne Colorectal Cancer StudyCancer Research 48(15):4399–404
Clapper, M. L. (2001). Chemoprevention of colorectal cancerCurrent Opinion in Oncology 13:307–13
Baron, J. A. (1999). Calcium supplements for the prevention of colorectal adenomas. Calcium Polyp Prevention Study GroupAmerican College of Physicians Journal Club 131(2):39
Schiffman, M. H., Bauer, H. M., Hoover, R. al. (1993). Epidemiologic evidence showing that human papillomavirus infection causes most cervical intraepithelial neoplasiaJournal of the National Cancer Institute 85:958–64
Lerman, C., Hughes, C., Croyle, R. al. (2000). Prophylactic surgery decisions and surveillance practices one year following BRCA1/2 testingPreventive Medicine 31(1):75–80
Freyer, G., Dazord, A., Schlumberger, al. (1999). Psychosocial impact of genetic testing in familial medullary-thyroid carcinoma: a multicentric pilot-evaluationAnnals of Oncology 10(1):87–95
Smith, K. R., West, J. A., Croyle, R. al. (1999). Familial context of genetic testing for cancer susceptibility: moderating effect of siblings' test results on psychological distress one to two weeks after BRCA1 mutation testingCancer Epidemiology, Biomarkers and Prevention 8(4 Pt 2):385–92
Evans, D. G., Blair, V., Greenhalgh, al. (1994). The impact of genetic counselling on risk perception in women with a family history of breast cancerBritish Journal of Cancer 70(5):934–8
Biesecker, B. B., Boehnke, M., Calzone, al. (1993). Genetic counseling for families with inherited susceptibility to breast and ovarian cancerJournal of the American Medical Association 269(15):1970–4
Billings, P. B. J. (1992). Genetic testing in the workplace: a view from the USATrends in Genetics 6:198–202
Ritvo, P., Robinson, G., Irvine, al. (2000). Psychological adjustment to familial genetic risk assessment: differences in two longitudinal samplesPatient Education and Counseling 40(2):163–72
Tercyak, K. P., Lerman, C., Peshkin, B. al. (2001). Effects of coping style and BRCA1 and BRCA2 test results on anxiety among women participating in genetic counseling and testing for breast and ovarian cancer riskHealth Psychology 20(3):217–22
Hatcher, M. B., Fallowfield, L., A'Hern, R. (2001). The psychosocial impact of bilateral prophylactic mastectomy: prospective study using questionnaires and semistructured interviewsBritish Medical Journal 322(7278):76
McNair, P. M., Lorr, M., Droppelman, L. (1971). EITSManual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service
Schwartz, M. D., Lerman, C., Miller, S. al. (1995). Coping disposition, perceived risk, and psychological distress among women at increased risk for ovarian cancerHealth Psychology 14(3):232–5
Diefenbach, M. A. (1993). Scales for assessing perceptions of health hazard susceptibilityHealth Education and Research 8(2):181–92
Audrain, J., Rimer, B., Cella, al. (1998). Genetic counseling and testing for breast-ovarian cancer susceptibility: what do women want?Journal of Clinical Oncology 16(1):133–8
Schwartz, M. D., Peshkin, B. N., Hughes., al. (2002). The impact of BRCA1/BRCA2 mutation testing on psychological distress in a clinic-based sampleJournal of Clinical Oncology 20(2):514–20
Lerman, C., Narod, S., Schulman, al. (1996). BRCA1 testing in families with hereditary breast-ovarian cancer. A prospective study of patient decision making and outcomesJournal of the American Medical Association 275(24):1885–92
Lerman, C., Hughes, C., Lemon, S. al. (1998). What you don't know can hurt you: adverse psychologic effects in members of BRCA1-linked and BRCA2-linked families who decline genetic testingJournal of Clinical Oncology 16(5):1650–4
Zigmond, A. S., Snaith, R. P. (1983). The hospital anxiety and depression scaleActa Psychiatrica Scandanavica 67:361–70
Lodder, L., Frets, P. G., Trijsburg, R. al. (2001). Psychological impact of receiving a BRCA1/BRCA2 test resultAmerican Journal of Medical Genetics 98(1):15–24
Zung, W. W., King, R. E. (1983). Identification and treatment of masked depression in a general medical practiceJournal of Clinical Psychiatry 44(10):365–8
Wagner, T. M., Moslinger, R., Langbauer, al. (2000). Attitude towards prophylactic surgery and effects of genetic counselling in families with BRCA mutations. Austrian Hereditary Breast and Ovarian Cancer GroupBritish Journal of Cancer 82(7):1249–53
Folkman, S. (1980). An analysis of coping in a middle-aged community sampleJournal of Health and Social Behavior 21(3):219–39
Hopwood, P. (2001). A body image scale for use with cancer patientsEuropean Journal of Cancer 37(2):189–97
Derogatis, L. R., Lipman, R. S., Rickels, al. (1974). The Hopkins symptoms checklist (HSCL): a measure of primary symptom dimensionsPsychological Measurements in Psychopharmacology 7:79–110
Derogatis, L. R., Melisaratos, N. (1983). The Brief Sympton Inventory: an introductory reportPsychological Medicine 13(3):595–605
Derogatis, L. R. (1977). SCL-90 Administration scoring and procedures. Manual-I to the (revised) version. Baltimore, MD: Johns Hopkins University School of Medicine
Dorval, M., Patenaude, A. F., Schneider, K. al. (2000). Anticipated versus actual emotional reactions to disclosure of results of genetic tests for cancer susceptibility: findings from p53 and BRCA1 testing programsJournal of Clinical Oncology 18(10):2135–42
Coyne, J. C., Benazon, N. R., Gaba, C. al. (2000). Distress and psychiatric morbidity among women from high-risk breast and ovarian cancer familiesJournal of Consulting Clinical Psychiatry 68(5):864–74
Miller, S. M. (1987). Monitoring and blunting: validation of a questionnaire to assess styles of information seeking under threatJournal of Personality and Social Psychology 52:345–53
Scheier, M. F., Carver, C. S. (1985). Optimism, coping, and health: assessment and implications of generalized outcome expectanciesHealth Psychology 4(3):219–47
Horowitz, M., Wilner, N., Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stressPsychosomatic Medicine 41(3):209–18
Grilli, R., Mainini, F., Penna, al. (1993). Inappropriate Halsted mastectomy and patient volume in Italian hospitalsAmerican Journal of Public Health 83(12):1762–4
Goldberg, D. P., Williams, P. (1988). A Users Guide to the General Health Questionnaire. Windsor: NFER-Nelson
Sherbourne, C. D., Stewart, A. L. (1991). The MOS Social Support SurveySocial Sciences and Medicine 32:705–15
First, M. B., Spitzer, R. L., Gibbon, M. et al. (1995). Structured Clinical Interview for DSM—IV Axis I Disorders — Patient Edition (SCID-I-P, Version 2.0). New York: Biometrics Research Dept., New York State Psychiatric Institute
Plon, S. E., Peterson, L. E., Friedman, L. al. (2000). Mammography behavior after receiving a negative BRCA1 mutation test result in the Ashkenazim: a community-based studyGenetics in Medicine 2(6):307–11
Metcalfe, K. A., Liede, A., Hoodfar, al. (2000). An evaluation of needs of female BRCA1 and BRCA2 carriers undergoing genetic counsellingJournal of Medical Genetics 37(11):866–74
Frost, M. H., Schaid, D. J., Sellers, T. al. (2000). Long-term satisfaction and psychological and social function following bilateral prophylactic mastectomyJournal of the American Medical Association 284(3):319–24
Payne, D. K., Biggs, C., Tran, K. al. (2000). Women's regrets after bilateral prophylactic mastectomyAnnals of Surgical Oncology 7(2):150–4
Collins, V., Halliday, J., Warren, al. (2000). Cancer worries, risk perceptions and associations with interest in DNA testing and clinic satisfaction in a familial colorectal cancer clinicClinical Genetics 58(6):460–8
Croyle, R. T., Smith, K. R., Botkin, J. al. (1997). Psychological responses to BRCA1 mutation testing: preliminary findingsHealth Psychology 16(1):63–72
Lynch, H. T., Lynch, J., Conway, al. (1994). Psychological aspects of monitoring high risk women for breast cancerCancer 74(3 Suppl.):1184–92
Lynch, H. T., Watson, P., Tinley, al. (1999). An update on DNA-based BRCA1/BRCA2 genetic counseling in hereditary breast cancerCancer Genetics and Cytogenetics 109(2):91–8
Women's use of coping strategies while waiting for genetic testing results (2000). Poster session presented at the annual meeting of the American Society of Preventive Oncology. Bethesda, MD
Lerman, C., Schwartz, M. (1993). Adherence and psychological adjustment among women at high risk for breast cancerBreast Cancer Research and Treatment 28(2):145–55
Kash, K. M., Holland, J. C., Halper, M. al. (1992). Psychological distress and surveillance behaviors of women with a family history of breast cancerJournal of the National Cancer Institute 84(1):24–30
Lerman, C., Caputo, C., Brody, D. (1990). Factors associated with inadequate cervical cancer screening among lower income primary care patientsJournal of the American Board of Family Practice 3(3):151–6
Lidbrink, E., Levi, L., Pettersson, al. (1995). Single-view screening mammography: psychological, endocrine and immunological effects of recalling for a complete three-view examinationEuropean Journal of Cancer 31A(6):932–3
Lazarus, R. S. (1974). Psychological stress and coping in adaptation and illnessInternational Journal of Psychiatry and Medicine 5(4):321–33
Wardle, J., Pope, R. (1992). The psychological costs of screening for cancerJournal of Psychosomatic Research 36(7):609–24
Olsson, P., Armelius, K., Nordahl, al. (1999). Women with false positive screening mammograms: how do they cope?Journal of Medical Screening 6(2):89–93
Skrabanek, P. (1985). False premises and false promises of breast cancer screeningLancet 2(8450):316–20
Aro, A. R., Absetz, Pilvikki S., Elderen, T. al. (2000). False-positive findings in mammography screening induces short-term distress — breast cancer-specific concern prevails longerEuropean Journal of Cancer 36(9):1089–97
Aro, A. R., Absetz-Ylostalo, P., Eerola, al. (1996). Pain and discomfort during mammographyEuropean Journal of Cancer 32A(10):1674–9
Bennetts, A., Irwig, L., Oldenburg, al. (1995). PEAPS-Q: A questionnaire to measure the psychosocial effects of having an abnormal pap smear. Psychosocial Effects of Abnormal Pap Smears QuestionnaireJournal of Clinical Epidemiology 48(10):1235–43
Bennett, A. K. (1995). Overview of 1995 PIAA Breast Cancer StudyMissouri Medicine 92(10):624–6
Wolfe, C., Doherty, I., Raju, K. al. (1992). First steps in the development of an information and counselling service for women with an abnormal smear resultEuropean Journal of Obstetrics, Gynecology and Reproductive Biology 45(3):201–6
Tomaino-Brunner, C., Freda, M. C., Damus, al. (1998). Can precolposcopy education increase knowledge and decrease anxiety?Journal of Obstetrics, Gynecology and Neonatal Nursing 27(6):636–45
Nugent, L. S., Tamlyn-Leaman, K., Isa, al. (1993). Anxiety and the colposcopy experienceClinical Nursing Research 2(3):267–77
Gath, D. H., Hallam, N., Mynors-Wallis, al. (1995). Emotional reactions in women attending a UK colposcopy clinicJournal of Epidemiology and Community Health 49(1):79–83
Somerset, M. (1998). Intervening to reduce anxiety for women with mild dyskaryosis: do we know what works and why?Journal of Advanced Nursing 28(3):563–70
Palmer, A. G., Tucker, S., Warren, al. (1993). Understanding women's responses to treatment for cervical intra-epithelial neoplasiaBritish Journal of Clinical Psychology 32(Pt 1):101–12
Marteau, T. M. (1990). Screening in practice: reducing the psychological costsBritish Medical Journal 301(6742):26–8
Sutton, S., Saidi, G., Bickler, al. (1995). Does routine screening for breast cancer raise anxiety? Results from a three wave prospective study in EnglandJournal of Epidemiology and Community Health 49(4):413–18
Brett, J., Austoker, J., Ong, G. (1998). Do women who undergo further investigation for breast screening suffer adverse psychological consequences? A multi-centre follow-up study comparing different breast screening result groups five months after their last breast screening appointmentJournal of Public Health Medicine 20(4):396–403
Ong, G., Austoker, J., Brett, J. (1997). Breast screening: adverse psychological consequences one month after placing women on early recall because of a diagnostic uncertainty. A multicentre studyJournal of Medical Screening 4(3):158–68
Essink-Bot, M. L., Koning, H. J., Nijs, H. al. (1998). Short-term effects of population-based screening for prostate cancer on health-related quality of lifeJournal of the National Cancer Institute 90(12):925–31
Diefenbach, M. A. (1999). Specific worry about breast cancer predicts mammography use in women at risk for breast and ovarian cancerHealth Psychology 18(5):532–6
Andrykowski, M. A., Curran, S. L., Studts, J. al. (1996). Psychosocial adjustment and quality of life in women with breast cancer and benign breast problems: a controlled comparisonJournal of Clinical Epidemiology 49(8):827–34
Lampic, C., Thurfjell, E., Bergh, al. (2001). Short- and long-term anxiety and depression in women recalled after breast cancer screeningEuropean Journal of Cancer 37(4):463–9
Bull, A., Mountney, L., Sanderson, H. (1991). Stage distribution of breast cancer: a basis for the evaluation of breast screening programmesBritish Journal of Radiology 64(762):516–19
Scaf-Klomp, W., Sanderman, R., Wiel, H. al. (1997). Distressed or relieved? Psychological side effects of breast cancer screening in The NetherlandsJournal of Epidemiology and Community Health 51(6):705–10
Gilbert, F. J., Cordiner, C. M., Affleck, I. al. (1998). Breast screening: the psychological sequelae of false-positive recall in women with and without a family history of breast cancerEuropean Journal of Cancer 34(13):2010–14
Bell, S., Porter, M., Kitchener, al. (1995). Psychological response to cervical screeningPreventive Medicine 24(6):610–16
Thiis-Evensen, E., Wilhelmsen, I., Hoff, G. al. (1999). The psychologic effect of attending a screening program for colorectal polypsScandinavian Journal of Gastroenterology 34(1):103–9
Beck, A. T., Steer, R. A. (1993). Beck Depression Inventory Manual. San Antonio, TX: Harcourt Brace
Northouse, L. L., Jeffs, M., Cracchiolo-Caraway, al. (1995). Emotional distress reported by women and husbands prior to a breast biopsyNursing Research 44(4):196–201
Snaith, R. P. (1976). The Leeds scales for the self-assessment of anxiety and depressionBritish Journal of Psychiatry 128:156–65
Steggles, S., Lightfoot, N., Sellick, S. M. (1998). Psychological distress associated with organized breast cancer screeningCancer Prevention and Control 2(5):213–20
Taylor, K. L., DiPlacido, J., Redd, W. al. (1999). Demographics, family histories, and psychological characteristics of prostate carcinoma screening participantsCancer 85(6):1305–12
Watson, D., Clark, L. A., Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scalesJournal of Personality and Social Psychiatry 54(6):1063–70
Lauver, D. R., Kruse, K., Baggot, A. (1999). Women's uncertainties, coping, and moods regarding abnormal Papanicolaou resultsJournal of Womens Health and Gender-Based Medicine 8(8):1103–12
Sjoberg, L. (1979). The measurement of moodScandinavian Journal of Psychology 20(1):1–18
Taylor, J. A. (1953). A personality scale of manifest anxietyJournal of Abnormal Social Psychology 48:285–90
Kerner, J. F., Yedidia, M., Padgett, D. et al. (2003). Realizing the promise of breast cancer screening: clinical follow-up after abnormal screening among black women. Preventive Medicine 37:92–101
Billings, A. G. (1981). The role of coping responses and social resources in attenuating the stress of life eventsJournal of Behavioral Medicine 4(2):139–57
Rosenberg, M. (1965). Society and the Adolescent Self Image. Princeton, NJ: Princeton University Press
Abi Rafi, A. (1965). The Maudsley Personality INVENTORY: a cross-cultural studyBritish Journal of Social and Clinical Psychology 4(4):266–8
Cooper, P., Osborn, M., Gath, D. H. (1982). Evaluation of a modified self-report measure of social adjustmentBritish Journal of Psychiatry 141:68–75
Miller, S. M., Roussi, P., Altman, al. (1994). Effects of coping style on psychological reactions of low-income, minority women to colposcopyJournal of Reproductive Medicine 39(9):711–18
Deiner, E., Emmons, R., Larsen, R., Griffin, S. (1985). The satisfaction with life scaleJournal of Personality Assessment 49:71–5
Smilkstein, G., Zimlich, R. (1990). A stress scale validation study. An instrument for psychosocial stressor assessment. New York, NY: Oxford University Press
Boer, H. Psychosocial effects of breast cancer screening. University of Twente 1993. Dissertation
Lau, R. R. Jr. (1981). Refinements in the measurement of health-specific locus-of-control beliefsMedical Care 19(11):1147–58
Kellner, R. (1987). Psychological measurements in somatization and abnormal illness behaviorAdvances in Psychosomatic Medicine 17:101–18
Walker, L. G., Cordiner, C., Gilbert, F. J. (1994). How distressing is attendance for routine breast screeningPsycho-Oncology 3:299–304
Dean, C., Roberts, M. M., French, al. (1986). Psychiatric morbidity after screening for breast cancerJournal of Epidemiology and Community Health 40(1):71–5
Ellman, R., Angeli, N., Christians, al. (1989). Psychiatric morbidity associated with screening for breast cancerBritish Journal of Cancer 60(5):781–4
Cockburn, J., Luise, T., Hurley, al. (1992). Development and validation of the PCQ: a questionnaire to measure the psychological consequences of screening mammographySocial Science and Medicine 34(10):1129–34
Lowe, J. B., Balanda, K. P., Del Mar, al. (1999). Psychologic distress in women with abnormal findings in mass mammography screeningCancer 85(5):1114–18
Spanier, G. B. (1976). Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyadsJournal of Marriage and Family 38:15–28
Eysenck, H. J., Eysenck, S. B. G. (1963). The Eysenck Personality Inventory. London: University of London Press
Mishel, M. H. (1981). The measurement of uncertainty in illnessNursing Research 30(5):258–63
Veit, C. T., Ware, J. E. Jr. (1983). The structure of psychological distress and well-being in general populationsJournal of Consulting Clinical Psychology 51:730–42
Lerman, C., Miller, S. M., Scarborough, al. (1991). Adverse psychologic consequences of positive cytologic cervical screeningAmerican Journal of Obstetrics and Gynecology 165(3):658–62
Stillman, M. J. (1977). Women's health beliefs about breast cancer and breast self-examinationNursing Research 26(2):121–7
Fallowfield, L. J., Rodway, A., Baum, M. (1990). What are the psychological factors influencing attendance, non-attendance and re-attendance at a breast cancer screening centreJournal of the Royal Society of Medicine 83(9):547–551
Slenker, S. E., Grant, M. C. (1989). Attitudes, beliefs, and knowledge about mammography among women over forty years of ageJournal of Cancer Education 4(1):61–5
Naughton, C. K. (2001). Impact of transrectal ultrasound guided prostate biopsy on quality of life: a prospective randomized trial comparing 6 versus 12 coresJournal of Urology 165(1):100–3
EuroQOL Group. (1990). EuroQol — a new facility for the measurement of health related quality of lifeHealth Policy 16:199–208
Volk, R. J., Cantor, S. B., Spann, S. al. (1997). Preferences of husbands and wives for prostate cancer screeningArchives of Family Medicine 6(1):72–6
Torrance, G. W. (1987). Utility approach to measuring health-related quality of lifeJournal of Chronic Disease 40:593–600
Gram, I. T., Lund, E., Slenker, S. E. (1990). Quality of life following a false positive mammogramBritish Journal of Cancer 62(6):1018–22
Dominitz, J. A., Provenzale, D. (1997). Patient preferences and quality of life associated with colorectal cancer screeningAmerican Journal of Gastroenterology 92(12):2171–8
Haes, J. C., Koning, H. J., Oortmarssen, G. al. (1991). The impact of a breast cancer screening programme on quality-adjusted life-yearsInternational Journal of Cancer 49(s):538–44
Orbell, S. (1996). Cognition and affect after cervical screening: the role of previous test outcome and personal obligation in future uptake expectationsSocial Science and Medicine 43(8):1237–43
Wilson, J. D., Hines, B. (2000). Nurse counselling for women with abnormal cervical cytology improves colposcopy and cytology follow up attendance ratesSexually Transmitted Infections 76(4):322
Paskett, E. D., Carter, W. B., Chu, al. (1990). Compliance behavior in women with abnormal Pap smears. Developing and testing a decision modelMedical Care 28(7):643–56
Reelick, N. F., Haes, W. F., Schuurman, J. H. (1984). Psychological side-effects of the mass screening on cervical cancerSocial Science and Medicine 18(12):1089–93
Pisano, E. D., Earp, J., Schell, al. (1998). Screening behavior of women after a false-positive mammogramRadiology 208(1):245–9
Pisano, E. D., Earp, J. A., Gallant, T. L. (1998). Screening mammography behavior after a false positive mammogramCancer Detection and Prevention 22(2):161–7
Gram, I. T., Slenker, S. E. (1992). Cancer anxiety and attitudes toward mammography among screening attenders, nonattenders, and women never invitedAmerican Journal of Public Health 82(2):249–51
Schwartz, L., Woloshin, S., Sox, al. (2000). US women's attitudes to false-positive mammography results and detection of ductal carcinoma in situ: cross-sectional surveyOriginal Research 173:307–9
Benedict, S., Williams, R. D., Baron, P. L. (1994). The effect of benign breast biopsy on subsequent breast cancer detection practicesOncology Nursing Forum 21(9):1467–75
Lindfors, K. K., O'Connor, J., , Parker, R. A. (2001). False-positive screening mammograms: effect of immediate versus later work-up on patient stressRadiology 218(1):247–253
Lindholm, E., Berglund, B., Kewenter, al. (1997). Worry associated with screening for colorectal carcinomasScandinavian Journal of Gastroenterology 32(3):238–45
Mant, D., Fitzpatrick, R., Hogg, al. (1990). Experiences of patients with false positive results from colorectal cancer screeningBritish Journal of General Practice 40(339):423–5
Winawer, S. J., Miller, C., Lightdale, al. (1987). Patient response to sigmoidoscopy. a randomized, controlled trial of rigid and flexible sigmoidoscopyCancer 60(8):1905–8
Drossman, D. A., Brandt, L. J., Sears, al. (1996). A preliminary study of patients' concerns related to GI endoscopyAmerican Journal of Gastroenterology 91(2):287–91
McCarthy, B. D., Moskowitz, M. A. (1993). Screening flexible sigmoidoscopy: patient attitudes and complianceJournal of General Internal Medicine 8(3):120–5
Pedersen, K. V., Carlsson, P., Varenhorst, al. (1990). Screening for carcinoma of the prostate by digital rectal examination in a randomly selected populationBritish Medical Journal 300(6731):1041–4
Myers, R. E., Hyslop, T., Wolf, T. al. (2000). African-American men and intention to adhere to recommended follow-up for an abnormal prostate cancer early detection examination resultUrology 55(5):716–20
Lauver, D., Rubin, M. (1991). Women's concerns about abnormal Papanicolaou test resultsJournal of Obstetrics, Gynecology, and Neonatal Nursing 20(2):154–9
Quilliam, S. (1989). Emotional aspects of positive smearsHealth Visit 62(10):308–9
Wardle, J., Sutton, S., Williamson, al. (2000). Psychosocial influences on older adults' interest in participating in bowel cancer screeningPreventive Medicine 31(4):323–34
Auvinen, A. (1996). Prospective evaluation plan for randomised trials of prostate cancer screening. The International Prostate Cancer Screening Trial Evaluation GroupJournal of Medical Screening 3(2):97–104
Kramer, B. S. (1993). Prostate cancer screening: what we know and what we need to knowAnnals of Internal Medicine 119(9):914–23
Carvalhal, G. F., Smith, D. C., Ramos, al. (1999). Correlates of dissatisfaction with treatment in patients with prostate cancer diagnosed through screeningJournal of Urology 162(1):113–18
Stewart-Brown, S. F. A. (1997). Screening could seriously damage your healthBritish Medical Journal 1314(7080):533–4
Cockburn, J., Staples, M., Hurley, S. al. (1994). Psychological consequences of screening mammographyJournal of Medical Screening 1(1):7–12
Gerard, K., Salkeld, G., Hall, J. (1990). Counting the costs of mammography screening: first year results from the Sydney studyMedical Journal of Australia 152(9):466–71
Rimer, B. K., Bluman, L. G. (1997). The psychosocial consequences of mammographyJournal of the National Cancer Institute Monographs 22:131–8
Fletcher, S. W. (1999). False-positive screening mammograms: good news, but more to doAnnals of Internal Medicine 131(1):60–2
Sickles, E. A. (1991). Periodic mammographic follow-up of probably benign lesions: results in 3,184 consecutive casesRadiology 179(2):463–8
Breen, N., Wagener, D. K., Brown, M. al. (2001). Progress in cancer screening over a decade: results of cancer screening from the 1987, 1992, and 1998 National Health Interview SurveysJournal of the National Cancer Institute 93(22):1704–13
Olivotto, I. A., Kan, L., Coldman, A. J. (1998). False positive rate of screening mammographyNew England Journal of Medicine 339(8):560
Elmore, J. G., Barton, M. B., Moceri, V. al. (1998). Ten-year risk of false positive screening mammograms and clinical breast examinationsNew England Journal of Medicine 338(16):1089–96
Lidbrink, E., Elfving, J., Frisell, al. (1996). Neglected aspects of false positive findings of mammography in breast cancer screening: analysis of false positive cases from the Stockholm trialBritish Medical Journal 312(7026):273–6
Lipkus, I. M., Halabi, S., Strigo, T. al. (2000). The impact of abnormal mammograms on psychosocial outcomes and subsequent screeningPsycho-Oncology 9(5):402–10
Veit, C. T., Ware, J. E. Jr. (1983). The structure of psychological distress and well-being in general populationsJournal of Consulting Clinical Psychology 51(5):730–42
Fallowfield, L. (1990). The Quality of Life: The Missing Measurement in Health Care. New York, NY: Oxford University Press
Mould, T. A., Rodgers, M. E., Singer, A. (1995). The psychological reaction of women to a colposcopy clinicBritish Journal of Obstetrics and Gynecology 102(5):428–9
Campion, M. J., Brown, J. R., McCance, D. al. (1988). Psychosexual trauma of an abnormal cervical smearBritish Journal of Obstetrics and Gynecology 95(2):175–81
Pisano, E. D. (1998). Screening behavior of women after a false-positive mammogramRadiology 208(1):245–9
Miller, A. B. (1993). Canadian National Breast Screening Study: public health implicationsCanadian Journal of Public Health 84(1):14–16
Lerman, C. E. (1993). Psychosocial impact of cancer screeningOncology (Huntington) 7(4):67–72
Gotay, C. C. (1984). The experience of cancer during early and advanced stages: the views of patients and their matesSocial Science and Medicine 18(7):605–13
Weil, J. G. (1997). Positive findings of mammography may lead to suicideBritish Medical Journal 314(7082):754–5
Fentiman, I. S. (1988). Pensive women, painful vigils: consequences of delay in assessment of mammographic abnormalitiesLancet 1(8593):1041–2
McCarthy, B. D. (1997). Screening mammography use: the importance of a population perspectiveAmerican Journal of Preventive Medicine 12(2):91–5
Kerner, J. F., Mandelblatt, J. S., Silliman, R. al. (2001). Screening mammography and breast cancer treatment patterns in older womenBreast Cancer Research and Treatment 69(1):81–91
Burman, M. L. (1999). Effect of false-positive mammograms on interval breast cancer screening in a health maintenance organizationAnnals of Internal Medicine 131(1):1–6
Stidley, C. A., Tollestrup, K., Frost, al. (2001). Mammography utilization after a benign breast biopsy among Hispanic and non-Hispanic womenCancer 91(9):1716–23
Bull, A. R., Campbell, M. J. (1991). Assessment of the psychological impact of a breast screening programmeBritish Journal of Radiology 64(762):510–15
McCaul, K. D., Schroeder, D. M., Reid, P. A. (1996). Breast cancer worry and screening: some prospective dataHealth Psychology 15(6):430–3
Feeny, this volume, Chapter 4
Gold, M. R., Siegel, J. E., Russell, L. B. et al. (1996). Cost-Effectiveness in Health and Medicine. New York, NY: Oxford University Press
Olsson, P., Armelius, K., Nordahl, G. (1999). Women with false postivie screening mammograms: how do they cope?Journal of Medical Screening 6(2):89–93
Pater, J., Osoba, D., Zee, al. (1998). Effects of altering the time of administration and the time frame of quality of life assessments in clinical trials: an example using the EORTC QLQ-C30 in a large anti-emetic trialQuality of Life Research 7(3):273–8
Katz, S. (1963). Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychological functionJournal of the American Medical Association 185:914–19
Llewellyn-Thomas, H., Sutherland, H. J., Tibshirani, al. (1982). The measurement of patients'values in medicineMedical Decision Making 2(4):449–62
Nord, E., Pinto, J. L., Richardson, al. (1999). Incorporating societal concerns for fairness in numerical valuations of health programmesHealth Economics 8(1):25–39
Dolan, P., Gudex, C. (1995). Time preference, duration and health state valuationsHealth Economics 4(4):289–99
Torrance, G. W. (1976). Toward a utility theory foundation for health status index modelsHealth Services Research 11:349–69