Short-term impact of cardiovascular screening by traditional risk assessment or coronary artery calcium score on health-related quality of life: the ROBINSCA trial.

Aims: Evidence on the impact of screening for cardiovascular diseases (CVDs) on health-related quality of life (HRQoL) is important for policy decisions about screening implementation and to uncover teachable moments to motivate healthy lifestyle choices. It is unknown whether screening by cardiac computed tomography (CT) scan has a stronger impact on HRQoL than screening by traditional risk prediction models. The study aims to investigate differences in HRQoL across the screening process between participants who were randomized to CVD risk estimation by coronary artery calcium score or Systematic COronary Risk Evaluation.
Methods and Results: A subset of 2687 ROBINSCA participants filled in questionnaires at (T0) randomization, (T1) invitation, (T2) 1-3 days before screening, (T3) 1-3 days after, and (T4) screening result. Generic HRQoL (SF-12; EQ-5D) and anxiety (STAI-6) were measured. We investigated the differences in changes in HRQoL across the screening process with linear mixed models. We found comparable levels of HRQoL at all screening moments for the two intervention groups. Mental health scores were worse at invitation and randomization than at the later time points, irrespective of screening group (all P < 0.001). A result indicating a heightened CVD risk was associated with increased anxiety in the CT screening group.
Conclusion: Computed tomography screening for CVD risk has no detrimental impact on HRQoL and anxiety levels compared to screening by traditional risk assessment. Receiving an invitation to screenning or a result implying increased CVD risk could function as teachable moments for high-risk individuals.
Registration: ROBINSCA trial registration number: NTR6471 in Dutch Trial Register (NTR).
Competing Interests: Conflict of interest: D.M. reports grants from European Commission—Horizon 2020, outside the conduct of this study. H.J.K. reports an advanced grant from the European Research Council during conduct of the study and grants from European Commission—Horizon 2020, outside the conduct of the study. M.V. reports supports for attending meetings and travel by the British Society of Cardiovascular Imaging, outside of the conduct of this study. R.V. reports grants from Siemens, the Dutch Heart Foundation, The Netherlands Organisation for Health Research and Development, and the Dutch Cancer Foundation, outside the conduct of this study. C.M.v.d.A. reports grants from the European Research Council during conduct of the study and fiduciary role in the B3 user commitee outside the conduct of the study. The authors have no other conflicts of interest to declare.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)