A1700 CT-Screening for lung cancer does not increase the use of anxiolytic or antidepressant medication

Tuesday, March 20, 2012
Ground Floor (Cancun Center)
Linda Kaerlev, Centre for National Clinical Databases, South, Odense University Hospital, Odense C, Denmark
Maria Iachina, Centre for National Clinical Databases, South, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
Jesper Holst Pedersen, Department of Cardiothoracic Surgery RT, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
Anders Green, Centre for National Clinical Databases, South, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
Bente Mertz Nørgård, Centre for National Clinical Databases, South, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
Introduction
Screening for serious diseases in occupational or lifestyle related target groups has been more common in the recent years. CT screening for lung cancer has recently been shown to reduce lung cancer mortality, but screening may also have adverse mental health effects. We calculated risk ratios for prescription of anti-depressive (AD) or anxiolytic (AX) medication redeemed at pharmacies during an up to 3.5 year follow up period 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 Oct 2004 until March 2006 to either CT scan of the chest, lung-function test and filled in questionnaires annually for five years in the period 01.4.2006-31.03.2010 (n=2,052) or a control group receiving similar procedures except CT scan. Outcome data on AD or AX was obtained by linkage to The Danish Medicinal Product Registry. 

Results
The intervention and the control groups did not differ by age, gender, civic status, socio-economic position (SES), comorbidity index (CCI) or former use of AD or AXs. The adjusted risk ratio for at least 2 recipes of ADs and AXs combined in the intervention group during follow-up was not increased, neither when adjusting for previous use of AD or AX, HR 094, 95% CI (0.81-1.10), nor when excluding subjects using AD or AX in a 4 month period before baseline, when analyzing AD and AX separately, or requiring only one recipe. Interestingly the CCI after 3 years of follow up were 54% increased both in the CT intervention and in the control group. 

Discussion
We found no indications that participation in a lung cancer CT-screening programme increases the risk of specific adverse mental health outcomes. The finding with increased CCIs may be an effect of smoking and needs to be studied further.

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