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False-positive test results influence receipt of future cancer screenings
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Individuals who received a false-positive breast or prostate cancer screening appeared more likely to undergo screening in the future, according to findings published in Cancer.
“False-positive cancer screening test results are common. Over 10 years, approximately 50% to 61% of women undergoing annual mammography and 10% to 12% of men undergoing PSA testing will experience a false-positive result,” Glen Taksler, PhD, assistant professor of medicine at Cleveland Clinic, and colleagues wrote.
Studies have shown the psychological toll that false-positive results take on patients.
“False-positive cancer screening test results may affect an individual’s willingness to continue screening for cancer in the future; approximately 40% of women experiencing a false-positive mammogram labeled the experience as ‘very scary’ or ‘the scariest time of my life,’” the researchers wrote.
However, it was unclear whether this experience encouraged or discouraged future screening participation.
Taksler and colleagues performed logistic regression analysis of 2006 to 2015 medical records from 92,405 individuals aged 50 to 75 years, reviewing a total of 450,484 person-years of data.
Researchers defined exposure to false-positive results as false-positive breast, prostate or colorectal cancer screening results. These included repeat breast imaging or negative breast biopsy 3 months or less after screening mammography, repeat PSA testing 3 months or less after a 4 ng/mL or greater test result or after any PSA result, or negative colonoscopy 6 months or less after a positive fecal occult blood test.
Up-to-date status with breast or colorectal screening served as the main outcomes. Researchers excluded prostate cancer screening status because guidelines at the time recommended against routine screening.
Women who previously experienced false-positive mammography results appeared more likely to be up-to-date with their breast cancer screenings (adjusted OR without breast biopsy = 1.43; 95% CI, 1.34-1.52; adjusted OR with negative breast biopsy = 2.02; 95% CI, 1.56-2.62). Further, these women also appeared more likely to be up to date in terms of screening for colorectal cancer (adjusted OR without breast biopsy = 1.25; 95% CI, 1.18-1.32; adjusted OR with negative breast biopsy = 1.47; 95% CI, 1.23-1.77).
However, women who experienced previous false-positive colorectal cancer fecal occult blood test results appeared less likely to be up to date on their breast cancer screenings (adjusted OR = 0.73; 95% CI, 0.61-0.81).
Men who had experienced false-positives PSA testing appeared more likely to have up-to-date colorectal cancer screenings (adjusted OR without prostate imaging or biopsy = 1.22; 95% CI, 1.01-1.48; adjusted OR with negative imaging/biopsy = 1.6; 95% CI, 1.05-2.42).
These results appeared stronger among patients who had experienced multiple false-positives.
“We don’t know why the observed pattern occurred,” Taksler said in a press release. “False positives are a limitation of the technology that we use to check for cancer. Hopefully, over time, the technology will improve so that patients don’t have to deal with as many false positives.” – by Andy Polhamus
Disclosures: Taksler reports no relevant financial disclosures. One author previously held a consulting role with the Informed Medical Decisions Foundation, now part of the nonprofit Healthwise, outside of the submitted work.
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