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False-positive mammograms may lead to future screening delays
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Women who received a false-positive mammogram result were more likely to put off getting future screening, according to research recently released in Cancer Epidemiology, Biomarkers and Prevention.
“Experiencing a false positive screening mammogram is economically, physically and emotionally burdensome, which may affect future screening behavior by delaying the next scheduled mammogram or by avoiding screening altogether,” Firas M. Dabbous, PhD, Advocate Health Care, Park Ridge, Illinois, and colleagues wrote.
Dabbous and colleagues analyzed 741,150 screening mammograms, of which 90,918 were false-positive and the rest were true-negative. They reported that the women who received a false-positive result were less likely to have a future screening mammogram on file than women who had true negatives (22.1% vs. 15%, P < .001). In addition, the average delay to come back for another mammogram was higher in those with false positives compared to those with true negatives (13 months vs. 3 months, P < .001). In an adjusted proportional hazards model, women with true negatives were more likely to return to screening in the next 3 years compared with those with false positives (HR = 1.36, 95% CI, 1.35-1.37). They also reanalyzed the data using different statistical methods to exclude the possibility of bias, and found that women who had a true-negative result were 34% more likely to return for a subsequent screen than those who had a false-positive result, and that the 4-year cumulative risk for a late stage cancer diagnosis was 0.4% for those who had a false positive compared with 0.3% for those who had a true negative.
“[These] findings must be interpreted with caution specifically because we do not know how many of those who do not come back to screening actually go to a different organization for their care,” Dabbous told Healio Family Medicine. “However, the findings are consistent, such that false-positive women tend to delay their next screen more than true-negative women, with the results from the analyses in which we restricted the dataset to those who actually come back for screening.”
Dabbous described how medical professionals can keep patients who receive false-positive results from falling through the cracks.
“All specialties … can be more engaged in counseling their patients who experience a false-positive result and encourage them to return for their next screening mammogram. At our organization, Advocate Health Care, radiologists make time to counsel women with false-positive mammograms and encourage them to return for annual screening mammography,” he told Healio Family Medicine. “Moreover, women of all screening ages receive routine electronic medical record-generated letters in regards to their next screen.” – by Janel Miller
Disclosure: Dabbous reports no relevant financial disclosures. Please see the study for a list of all other authors’ relevant financial disclosures.