Effect of false-positive results on reattendance at breast cancer screening programmes in Spain

Álamo-Junquera, Dolores; Murta-Nascimento, Cristiane; Macià, Francesc; Baré, Marisa; Galcerán, Jaume; Ascunce, Nieves; Zubizarreta, Raquel; Salas, Dolores; Román, Rubén; Castells, Xavier; Sala, María

doi:10.1093/eurpub/ckr057

Cited by 28 publications

(22 citation statements)

References 23 publications

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“…The negative effect of false positives on screening retention is consistent with the findings from two-decade-old Canadian studies 11,21 and a more recent study conducted in Spain, where breast cancer screening is also free and is recommended biennially. 22 Retention rates were higher in the Spanish study than in ours: retention rates for women with false positive vs. normal results were 78.3% vs. 81.9%, compared to ours which were 68.1% vs. 68.7% respectively. Both studies found significantly lower retention rates, 66.5% (Spain) and 45.8% (Alberta) for those who underwent invasive procedures, including aspiration, closed biopsy and/or open biopsy.…”

Section: Discussioncontrasting

confidence: 64%

“…Both studies found significantly lower retention rates, 66.5% (Spain) and 45.8% (Alberta) for those who underwent invasive procedures, including aspiration, closed biopsy and/or open biopsy. 22 Invasive follow-up tests have been shown to create psychological distress in the context of false positive breast cancer screens, 23 which can last for up to three years; 7,24 it is likely that psychological distress plays an important role in screening retention.…”

Section: Discussionmentioning

confidence: 99%

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The impact of false positive breast cancer screening mammograms on screening retention: A retrospective population cohort study in Alberta, Canada

Shen

Winget

Yuan

2017

Can J Public Health

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OBJECTIVES:The impact of false positives on breast cancer screening retention is inconsistent across international studies. We investigate factors associated with screening retention, including false positive screening results, invasiveness of diagnostic procedures, and geographic variation in Alberta, Canada. METHODS:A total of 213 867 women aged 50-67 years who had an index screen mammogram between July 2006 and June 2008 were evaluated at 30 months post index screen to determine the screening retention rate. The association of screening retention with invasiveness of the diagnostic procedure, time to diagnostic resolution, and region of residence were investigated using multivariable log binomial regression, adjusting for women's age. RESULTS:Women with false positive screening results were less likely to return for their next recommended screening than those with a true negative result (62.0% vs. 68.7%). Compared to women with normal screening results, the adjusted risk ratios of fail-to-rescreen for women with imaging-only follow-up, needle sampling, and open biopsy were 1.08 (95% CI: 1.05-1.12), 1.72 (95% CI: 1.44-2.07) and 2.29 (95% CI: 2.09-2.50) respectively. Screening retention rates were slightly higher for rural residents than urban residents. Time to diagnostic resolution was not associated with screening retention. Screening retention peaked at one year from the index date of the previous screening.CONCLUSION: Higher awareness of the strong negative impact that biopsies in the case of a false positive screening have on screening retention is needed. Such awareness can inform intervention strategies to mitigate the impact and improve screening retention rate.KEY WORDS: Breast cancer; screening; retention; false positive La traduction du résumé se trouve à la fin de l'article.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

The impact of false positive breast cancer screening mammograms on screening retention: A retrospective population cohort study in Alberta, Canada

Shen

Winget

Yuan

2017

Can J Public Health

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“…The study size was comparable with similar studies performed in other countries 7,10,12,14 , although significantly smaller than some very large studies. 15,17,18 The screening services included in the study represent a balanced cross-section of the population in different parts of the country, and include ethnic minority communities and rural and inner city populations. Indices of multiple deprivation (IMDs) were obtained for those Primary Care Trusts (PCTs -the local commissioners of health care during the study period) whose main screening provider was one of the five programmes included in the study.…”

Section: Methodsmentioning

confidence: 99%

“…The meta-analysis was updated in 2011 16 with the addition of another two European studies 12,13 but with no change in the conclusion. Two further European studies 15,17 and a recently published study from Australia 18 found that false positive screening reduced subsequent attendance whereas a study of the Irish BreastCheck programme 14 found a small but significant increase in reattendance following false positive mammography.…”

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confidence: 99%

The effect of false positive breast screening examinations on subsequent attendance: retrospective cohort study

et al. 2013

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Objectives To investigate the effect of false positive breast screening examination results on subsequent attendance in the UK National Health Service Breast Screening Programme. Methods 253,017 previously screened women who were invited for rescreening were studied. Attendance rates of women who had received a normal result at the last (index) screen were compared with those of women who had received a false positive result. The effects of age, type of index screening examination ( prevalent or incident) and tissue sampling at assessment were investigated.Results Women who had a false positive prevalent index screening examination were significantly more likely to reattend than those who had a normal prevalent index screening examination (87.7% vs. 86.0%). There was no significant difference in reattendance rates between women who had a false positive incident index screening examination and those with a normal incident index screening examination. However, women who underwent needle sampling or open biopsy following false positive incident index screening examinations were 12% and 60% less likely to reattend, respectively, than women whose index screening examinations were normal ( p , 0.001), although there was variation between centres. Increasing age significantly reduced the likelihood of reattendance. The overall reattendance of women who had been screened only once was six percentage points lower than that of women who had been screened more than once. Conclusions The findings suggest that most women who undergo the breast screening assessment process retain confidence in breast screening. Needle sampling and open biopsy should be used judiciously in the assessment of screen-detected abnormalities in view of the reduced reattendance that results from their use after incident screening examinations.

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“…45 Absenting from screening consequently negates any benefits of the service and increases the mortality rate. 46 To ensure accurate and low falsepositive recall rates it is important to regularly measure screening performance parameters and provide feedback to screening personnel. 47 …”

Section: Psychological Impact Of Recallmentioning

confidence: 99%

A retrospective audit of the first screening round of the Maltese breast screening programme

2017

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Purpose: To analyse whether the screening performance parameters of the Maltese National Breast Screening Programme first screening round met requirements set by European standards. The association between screening age and results of screening performance parameters was also investigated. Method:Quantitative methodology was used to review examinations of women who were recalled for a technical recall or further assessment rates. All accessible members of the population recalled during the first round were retrospectively reviewed resulting in a sample of 2300 recalled examinations.Results: Malta's first screening round met the European Guidelines recommendations for technical repeat rate (0.26%), early recall rate (0.45%), breast cancer detection rate (13.77 per 1000 women) and Positive Predictive Value of screening test (7.58%). However, local recall rate (18.53%) and further assessment rate (18.27%) were higher than recommended.The Chi square test showed a statistically significant difference (p<0.05) in recall rates between the compared age groups, as younger women (51-55 years) were more likely to have a negative diagnosis after the initial mammogram whereas older women (56-60 years) were more likely to be recalled. There was no age discrepancy (p>0.05) in local breast cancer detection rate and positive predictive value of screening test. Conclusion:Although the Maltese first screening round performed well, this study found deficiencies in recall and further assessment rates, which according to literature may result in psychological morbidity and inefficient use of screening resources. This study also concluded that when a cohort is analysed, age is not as significant as the screening round itself (first/subsequent). KeywordsBreast cancer, breast screening programme, screening performance parameter, false positive mammogram, age effect IntroductionBreast cancer is the most common cancer among Maltese women and accounts for a third of all female cancer deaths. Every one in twelve Maltese women will get breast cancer in her lifetime; a significantly higher proportion than the European average. 1 In October 2009, Malta's Department for Health agreed to implement a National Breast Screening Programme (MNBSP). 2 The aim of screening was to reduce morbidity and mortality from the disease without adversely affecting the health of participants. 3,4 Key to achieving this aim were high levels of quality within the entire screening process. 4 The MNBSP strives to protect the dignity and privacy of women, while offering an effective service at the highest levels of quality to diagnose and treat breast cancers at the earliest possible stage, and also meeting the European clinical standards. 4 The first MNBSP round commenced in October 2009 and ended in February 2013. The local screening programme provided free screening, every three years for all women aged 50 to 60, resident in the Maltese Islands. This age range was selected for the first screening round since this age group was deemed to be the 'most at risk'...

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Effect of false-positive results on reattendance at breast cancer screening programmes in Spain

Abstract: A false-positive screening mammogram in the first screening negatively affected attendance at the subsequent screening. The results of this study could be useful to improve the screening process and to increase women's compliance.

Cited by 28 publications

References 23 publications

The impact of false positive breast cancer screening mammograms on screening retention: A retrospective population cohort study in Alberta, Canada

The impact of false positive breast cancer screening mammograms on screening retention: A retrospective population cohort study in Alberta, Canada

The effect of false positive breast screening examinations on subsequent attendance: retrospective cohort study

A retrospective audit of the first screening round of the Maltese breast screening programme

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