Meta-analyses of the effect of false-positive mammograms on generic and specific psychosocial outcomes (original) (raw)
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Systematic Review: The Long-Term Effects of False-Positive Mammograms
Annals of Internal Medicine, 2007
Background: Although abnormal screening mammograms deleteriously affect the psychological well-being of women during the time immediately surrounding the tests, their long-term effects are poorly understood. Purpose: To characterize the long-term effects of false-positive screening mammograms on the behavior and well-being of women 40 years of age or older. Data Sources: English-language studies from the MEDLINE, Web of Science, EMBASE, CINAHL, PsycINFO, and ERIC databases through August 2006. Study Selection: Studies were identified that examined the effects of false-positive results of routine screening mammography on women's behavior, well-being, or beliefs. Data Extraction: Two investigators independently coded study characteristics, quality, and effect sizes. Data Synthesis: 23 eligible studies (n ϭ 313 967) were identified. A random-effects meta-analysis showed that U.S. women who received false-positive results on screening mammography were more likely to return for routine screening than those who received normal results (risk ratio, 1.07 [95% CI, 1.02 to 1.12]). The effect was not statistically significant among European women (risk ratio, 0.97 [CI, 0.93 to 1.01]), and Canadian women were less likely to return for routine screening because of false-positive results (risk ratio, 0.63 [CI, 0.50 to 0.80]). Women who received false-positive results conducted more frequent breast self-examinations and had higher, but not apparently pathologically elevated, levels of distress and anxiety and thought more about breast cancer than did those with normal results. Limitations: Correlational study designs, a small number of studies, a lack of clinical validation for many measures, and possible heterogeneity. Conclusions: Some women with false-positive results on mammography may have differences in whether they return for mammography, occurrence of breast self-examinations, and levels of anxiety compared with women with normal results. Future research should examine how false-positive results on mammography affect other outcomes, such as trust and health care use.
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2015
Cancer screening aims to detect cancer at an asymptomatic stage, although side effects from screening also occur. We investigated the prevalence, longitudinal development, and predictors of psychosocial consequences of false-positive breast cancer screening. Three hundred ninety-nine women with false-positive screening mammography responded to the Consequences of Screening-Breast Cancer (COS-BC) questionnaire immediately after a negative diagnosis (free from breast cancer) following recall examination(s) (baseline), and 6 and 12 months later. Age-matched controls (n = 499) with a negative mammogram responded to the COS-BC at the same occasions. Five COS-BC scales (Sense of dejection, Anxiety, Behavioral, Sleep, and Existential values) were used as outcome measures. Women with false-positive mammography had consistently higher prevalence of all five consequences compared with controls (P < 0.001). The prevalences decreased between baseline and 6 months (P < 0.001) but were stab...
European Journal of Cancer, 2000
The aim of this study was to examine psychological distress in a mammography screening process as a consequence of screening after adjusting for background, personality and prescreening distress. Subjects, aged 50 years, were invitees at their ®rst screening. There were three groups; normal ®ndings (n=1407), false-positive ®ndings (n=492) and referents from outside the screening programme (n=1718, age 48±49 years). Distress was measured as illness worry, anxiety, depression, cancer beliefs and early detection behaviour. Measurements were one month before screening invitation with follow-ups at 2 and 12 months postscreening. At 2 months, there was a moderate multivariate eect of group on distress; and intrusive thinking and worry about breast cancer, in particular, were most frequent amongst the false positives. Intrusive thinking still prevailed at 12 months, in addition to a higher perceived breast cancer risk and susceptibility. Distress related to screening and false-positive ®ndings seems to be moderate, but prevailing cancer-speci®c concerns call for improvements in screening programmes.
Psychological consequences of false-positive screening mammograms in the UK
Evidence-based medicine, 2013
To identify the psychological effects of false-positive screening mammograms in the UK. Systematic review of all controlled studies and qualitative studies of women with a false-positive screening mammogram. The control group participants had normal mammograms. All psychological outcomes including returning for routine screening were permitted. All studies had a narrative synthesis. The searches returned seven includable studies (7/4423). Heterogeneity was such that meta-analysis was not possible. Studies using disease-specific measures found that, compared to normal results, there could be enduring psychological distress that lasted up to 3 years; the level of distress was related to the degree of invasiveness of the assessment. At 3 years the relative risks were, further mammography, 1.28 (95% CI 0.82 to 2.00), fine needle aspiration 1.80 (95% CI 1.17 to 2.77), biopsy 2.07 (95% CI 1.22 to 3.52) and early recall 1.82 (95% CI 1.22 to 2.72). Studies that used generic measures of anxi...
Quality of life following a false positive mammogram
British journal of cancer, 1990
To assess how women regard having had a false positive mammogram screening exam, and the influence that this had on their quality of life, 126 such women were interviewed. Their responses were compared to those of 152 women randomly selected among screenees with a negative exam. Eighteen months after the screening the reported prevalence of anxiety about breast cancer was 29% among women with a false positive and 13% among women with a negative screening mammogram (P = 0.001). Of 30 women biopsied, 8 (27%) had pain in the breast and 10 (33%) had reduced sexual sensitivity. A false positive mammogram was described by 7 (5%) of the women as the worst thing they ever had experienced. However, most women with a false positive result regarded this experience, in retrospect, as but one of many minor stressful experiences creating a temporary decrease in quality of life. They report the same quality of life today as women with negative screening results and 98% would attend another screeni...
Distressed or relieved? Psychological side effects of breast cancer screening in The Netherlands
Journal of Epidemiology & Community Health, 1997
Study objectives-To assess the psychological impact of mammographic screening on women with non-malignant outcomes after attending the Netherlands' National Breast Cancer Screening Programme. Design-During one year all women with false positive test results (95) in a screening area were invited for the study. Each false positive was matched with two women with normal mammograms with respect to age and municipality. A random reference group of 400 was drawn from the female population in an area not yet included in the screening programme. Experiences with screening and psychological status of subjects were assessed 8-10 weeks after screening (T1) and again after six months (T2), by interviews as well as questionnaires. References completed two questionnaires with a six months' interval. Participants-74 (78%) women with false positive outcomes and 113 (59%) women with negative outcomes participated at TI, of these 65 (88%) and 105 (93%) at T2, respectively; 238 references returned questionnaires at Ti (59%), of these 143 (60%) at T2.
Scandinavian Journal of Primary Health Care, 2018
Background: Mammography screening may cause psychosocial harm for women experiencing a false-positive screening result. Previous studies suggest long-term consequences. The aim of the present study was to assess psychosocial consequences of false-positive findings on screening mammography within a six month follow-up. Methods: A prospective matched cohort survey study using the questionnaire 'Consequences of Screening for Breast Cancer' (COS-BC), which was translated from Danish to Norwegian. Psychometric analyses investigated the measurement properties of the Norwegian version. Two screening clinics in Norway distributed the survey to 299 women with an abnormal mammogram and 541 women with a normal screen. Women received the questionnaire when receiving the screening result, and one and six months after screening. Results: At six months, statistically significant differences appeared in two scales: existential values and breast examination. At six-month follow-up, women with false-positive results showed no statistically significant differences from women diagnosed with breast cancer in three outcomes: sense of dejection, anxiety, and keeping my mind off things. Conclusion: Our results indicate that the psychosocial consequences from having false-positive screening mammography results diminish after six months. The results support previous research describing breast-specific outcomes. However, our results indicate that Norwegian women are less frightened than other Scandinavian mammography screening participants.
Journal of racial and ethnic health disparities, 2016
Adverse psychological consequences of screening mammography are well-documented for women who receive a false positive result. Little is however known about ethnic differences. To address this gap, we examine distress associated with an abnormal mammogram (results-related distress) and perceived lifetime risk of breast cancer (perceived risk) among Latinas and Non-Latina White (NLW) women 3 months after receipt of a false positive result. A sample of 28 Latina and 27 NLW women who received an initial abnormal mammogram result and later a definitive noncancer diagnosis were recruited for this descriptive, longitudinal study. Women were interviewed twice: within 30 days and 3 months after a false positive result. Questionnaires included standard socio-demographic questions, the Impact of Events Scale-Revised, and two perceived breast cancer risk items. All participants experienced decreased distress three months after the initial results. Latinas experienced higher levels of distress, F(1,45) = 4.58, p = 0.04, and had a significant increase in perceived breast cancer risk over time, F(1,45) = 3.99, p = 0.05. Larger population-based studies are necessary to confirm ethnic differences in mental health consequences of false positive results. Given cultural emphases concerning respect for authority figures, healthcare professionals may be particularly helpful in working with Latinas to mitigate distress and clarify accurate perceptions of breast cancer risk through evidence-based practice.
The Breast
Objective: The impact of mammography screening recall on quality-of-life (QOL) has been studied in women at average risk for breast cancer, but it is unknown whether these effects differ by breast cancer risk level. We used a vignette-based survey to evaluate how women across the spectrum of breast cancer risk perceive the experience of screening recall. Methods: Women participating in mammography or breast MRI screening were recruited to complete a vignette-based survey. Using a numerical rating scale (0e100), women rated QOL for hypothetical scenarios of screening recall, both before and after benign results were known. Lifetime breast cancer risk was calculated using Gail and BRCAPRO risk models. Risk perception, trait anxiety, and breast cancer worry were assessed using validated instruments. Results: The final study cohort included 162 women at low (n ¼ 43, 26%), intermediate (n ¼ 66, 41%), and high-risk (n ¼ 53, 33%). Actual breast cancer risk was not a predictor of QOL for any of the presented scenarios. Across all risk levels, QOL ratings were significantly lower for the period during diagnostic uncertainty compared to after benign results were known (p < 0.05). In multivariable regression analyses, breast cancer worry was a significant predictor of decreased QoL for all screening scenarios while awaiting results, including scenarios with non-invasive imaging alone or with biopsy. High trait anxiety and family history predicted lower QOL scores after receipt of benign test results (p < 0.05). Conclusions: Women with high trait anxiety and family history may particularly benefit from discussions about the risk of recall when choosing a screening regimen.