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Biennial mammographic screening elevated false-positive risk
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One of every five women aged 50 to 69 years who participated in the Norwegian Breast Cancer Screening Program was found to have a false-positive screening result during the course of 10 biennial screening examinations, according to results of a retrospective review.
“False-positive screening results are an unavoidable part of breast cancer screening, and some risk of false-positive results must be accepted for adequate cancer detection,” Marta Roman, MSc, and colleagues from the department of epidemiology and evaluation at the Hospital del Mar Medical Research Institute in Barcelona wrote. “[However], the harm of false-positive recalls must be balanced against the goal of maintaining reasonable detection of early-stage cancers.”
To assess the estimates of the cumulative risk of a false-positive screening result and the risk of a recall for further assessment, including an invasive procedure with a benign outcome, researchers evaluated data on 231,310 women who underwent 715,311 mammographic screenings in the Norwegian Breast Cancer Screening Program from 1996 to 2010. All women were aged 50 or 51 years at the time of initial mammography screening
Roman and colleagues used generalized linear mixed models to estimate the probability of a false-positive screening result and to calculate the cumulative false-positive risk for up to 10 biennial screening examinations.
The cumulative false-positive risk after 20 years of biennial screening was 20% (95% CI, 19.7-20.4), and the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.1% (95% CI, 3.9-4.3). Researchers also calculated the following cumulative risks: undergoing fine-needle aspiration cytology, 1.4% (95% CI, 1.3-1.5); undergoing core needle biopsy, 2% (95% CI, 1.9-2.1); and undergoing open biopsy with a benign outcome, 0.16% (95% CI, 0.13-0.19).
“We found that irregular screening attendees had a higher false-positive risk of a false-positive screening result (OR=1.12; 95% CI, 1.06-1.20), and a nonstatistically significantly higher risk of an invasive procedure with a benign outcome (OR=1.11; 95% CI, 0.98-1.26) compared with regularly screened women,” Roman and colleagues wrote. “There is a need for further knowledge regarding the recalls of patients with negative outcomes, and how to reduce their associated harms.”
Disclosure:The researchers report grants from the NIH and GE Healthcare, as well as employment relationships with the Cancer Registry of Norway.
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